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!

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I totally agree with your post, as I gave birth (via C-Section ) to both of my children in the hospital. However, there are differences I experienced with both pregnancies at both hospitals. When I had my first son 4 years ago, the Hartford Hospital (Hartford, CT) birthing facilities were absolutely fabulous! I had a wonderful support staff of nurses, a wonderful midwife and obstetrician who helped me deliver. The accomidations were almost like giving birth at home, and my husband was able to room in with me. I had problems with my son's head not coming down the birth canal (it was later determined my pelvis was too small) and I had a C-Section that went smoothly and my son and I were well taken care of. The birth of my second son in October, 2008 didn't go as smoothly. I had my son at St. Peter's in New Jersey, and while the nursing staff and doctors were supportive, the accomidations left much to be desired. I had to share a room with another person whose visitors didn't respect my privacy as much. The birthing process was also not as positive - I had a scheduled C-Section of which the first spinal block only numbed the right side of my body & I had to get an epidural which meant a bit more discomfort. Then I had a lactation specialist who I describe as obsessed in her mission to get me to breastfeed while strapped to IV lines, and a healing incision above my bellybutton & below. I also missed having my midwife there as my support. I would just like to say that hospitals need to take more of a proactive role in providing a positive birth experience.
I agree...I am also a nurse and love doing natural births....I wish more women would speak up and make their needs known. I actively try to find patients that want to go more natural because I know they need me, but there are nurses and medical professionals who agree with natural birthing and love the philosophy. I admit though that I am about the only one that I know that would willing do a natural birth. Most of my colleges avoid them like the plague. If we lived in a perfect world we would have a beautiful hospital, homelike rooms, with super supportive staff and doctors, that knew how to do natural births, but still had the emergency equipment next door. I had two of my kids in a birth center that was a block away from the hospital. I was pre-registered there and if the need should arise, I could have been there in the amount of time it would take them to set up a c-section room. But it still felt like home and unnecessary interventions were not used. I wish we had more places like that.
I definitely agree that it is completely possible to have a positive experience in a hospital. The problem is that (for most women) you have to fight like hell to get it! Labor is the most vulnerable place a woman will ever be and to have to fight and say no, no, no, no, no for hours on end when you are in incredible pain just plain isn't fair to any woman. Plus, even hospitals that are more forward thinking many times let their patients down with a lack of resources. I had wonderful midwives and went to the only hospital in our state that does waterbirth. I wasn't going to be allowed to actually have a waterbirth (I'm a scary VBAC mom afterall!) but they were going to let me at least labor in the tub. BUT.....my baby decided to come on the same day as many, many others and not only was the waterbirth tub in use, but so was EVERY OTHER L&D ROOM!!! They gave me the choice of having my baby in triage or the OR!!!! Thankfully, at the last second, a room opened up and I was ushered in way after I should have been. So, instead of being peaceful and serene, it was hectic and full of chaos. Not my midwifes fault, not really anyones fault....just one more reason to be at home and out of "the system".

Oh, and I wanted to make one more comment that the hospital is not the only place a baby can be resusitated. I think that's one huge myth that BOBB shed light on. Homebirth midwives bring all kinds of equipment with them to handle all kinds of birth complications. A good friend of mine who had a homebirth....her husband is a paramedic and was really nervous about the "what if" stuff. He felt much better once he learned that the midwife would bring all kinds of equipment....he even took pictures of it all when she came (ok, so that's a bit goofy, but at least he felt good about it).
I think many women find that there ARE hospitals that are the enemy of a natural labor. My second birth was magnificent. My L&D nurse was fabulous. She was so supportive, kind, respectful, and, consequently, I made it to nearly completion before I chickened out and got the epidural. She just patted me on the back afterward, making me feel like a total hero, telling me that next time I COULD go all the way...to just have faith in myself.

The third baby was born under different circumstances, in a different hospital. My nurses fought with me (on behalf of the physician, of course) to consent to pitocin to speed up my labor (I had only been there for an hour or so, for the love of God). Then, after shift change, I got a new nurse with whom I discussed my desires for no epidural (now that I've already given in to the pit...its so hard to fight when you're in labor!). An hour later, that new nurse came in and, during a terrible pit contraction, SOLD the epidural to me, "Kayla, you'll never be able to handle it. They'll get horribly painful and, here soon, it will be too late. You don't want that to happen." I consented, just bawling the whole time. I was forced to stay in bed from minute one (for no reason, completely uncomplicated pregnancy and labor), never given the option of a birthing ball, there wasn't even a tub in the room. The hospital was naturally unfriendly to moms going for a natural labor. As was my obstetrician, which I'm sure was the biggest source of conflict. He actually laughed at me when I suggested using water for pain or for birth, "Um, hehe, we don't do that."

Afterward, when it was too late of course, I did my "rate" research. That particular hospital catered to the wealthier, more-likely-to-be-insured population of the area. They induced or augmented the labors with pitocin 95% of the time, 95% epidural rate, 98% epi or narcotic rate, and the hospital had a 50% section rate.

So, this, to me is a good place to start. While not every hospital is horrible and L&D nurses are not to be feared, you gotta check the hospitals that are more familiar with natural labors. If nearly 100% of the births the L&D nurse actually sees are augmented with an epidural, how the hell is he or she gonna know what to do with a woman laboring without pain meds? In fact, you find that many L&D nurses in those hospitals actually think that women who labor without pain meds are martyrs or, worse, stupid for that choice.

Just do your research. I loved my L&D nurse for my second birth. I send her pics of the babies every single year and I did something very nice for her after the birth itself. But, with three births and 10 L&D nurses under my belt, she was the only one who supported me. And its just the times. Poor nurses on the L&D floor are really understaffed, undereducated, and underpaid.

Also, I agree that babies can be rescuscitated by a trained midwife at home. Nurses on the L&D floor usually have associates in nursing degrees or, at best, a BSN. A certified nurse midwife is basically a nurse practitioner (with a masters in nursing and time in a midwifery program) specializing in maternal and newborn care. So a CNM who delivers at home is actually in a better position to care for a newborn in distress than the nursing staff at a hospital. Not to mention, most of the distress of newborns comes directly from the overuse and misuse of pitocin and epidural anesthesia, but that's another side of the story.

I also found out, a while back, that CNMs are actually trained to handle certain complications of vaginal deliveries (like breech presentation and shoulder dystocia) while protecting the vaginal delivery. Obstetricians just section those types of complications.
It definitely can.

Although I wanted a homebirth, it simply wasn't feasible and I had a midwife birth in hospital. I was able to labor in the shower for as long as I wanted, even with an IV (GBS+). I was able to move around (actually spent time laboring in two different rooms) and could have walked around the floor if I'd wanted to. Interventions were minimal and even now almost five years PP I still remain very pleased with the results.
I agree with you that villifying medical professionals is wrong, it certainly does not help the home birth movement at all. BUT unfortunately your situation is still, even now, very unusual. Hospitals are always going to be bound by "the fear of lawsuits" and this will always lead them to do what is safest for THEM. Hospitals and doctors can be sued for NOT doing a C-section, but DOING one that leads to possible complications will not get them sued. This is the world we live in. Its about choice. Women should be able to have a safe birth where ever they feel safest.
no, the hospital isn't horrible. however,

why FIGHT if you don't have to?

meaning, is labor really the time and place to be arguing with the nurses or doctor? i don' think so. and under the stress of labor, is not a time to give proper consent for anything.

i had 2 hospital vbacs - overall, they were very + experiences. but i had to always vocalize my desires (and put up with eye rolls or comments made under-their-breath. who needs that?!

i had a CNM for my first vbac and an OB for my 2nd. both were very good. i appreciated both of their expertise, that's why i went to them. it is important to communicate and have a truly supportive care provider, one that believes in birth and believes in our bodies, that we were made to do so.
I absolutely don't want to argue about what healthcare professional is "better" at resuscitating a baby, but do want to share a few facts. The CNM is a masters prepared nurse. Staff nurses on an OB unit are typically associates or bachelors prepared nurses. However, a neonatal nurse resuscitates babies on a very frequent basis. We are called to all problem deliveries, infant codes, etc. Nursing is so specialized; I wouldn't for a moment pretend to have the skills that a CNM does, and I don't work with a single CNM who would state that their skills in infant resuscitation are the same as a neonatal nurse. In most large hospitals, it isn't the L&D RN who provides high risk neonatal care, but the Special Care Nursery or NICU nurse (ie neonatal nurse). In fact, we often do it on our own, managing infants ourselves until a pediatrician or neonatologist arrives. The CNM provides expert prenatal care, great intrapartum care, but most wouldn't describe themselves as expert neonatal practitioners. I work (or have worked) with several midwives who would absolutley agree in the description of their skills and areas of expertise. In terms of equipment, it's great that they often bring the basics. They don't, however, have the countless supplies for all the "what ifs". We have store rooms in hospitals packed with so many supplies for so many different situations...umbilical line trays, chest tube trays, ET tubes... The need for different supplies presents itself throughout the time we provide high risk infant care. Also, it isn't uncommon to have multiple nurses/physicians working on one very sick infant. When I speak of hospitals having "help" available, sometimes it's in the form of simple manpower. A CNM in the home just doesn't have the same help or resources available, even if she is quite adept at infant resuscitation. As I said, I would never want to negate anyone's skills or contribution to our birth experiences. Just want moms to know how specialized nursing care is these days and talk a little about who usually does what when an infant is born who needs assistance. I have no doubt that many CNMs have saved the lives of countless babies, but the level of their degree alone isn't what separates them from the staff nurse:)
I work in labor and delivery and post partum and where I live, no one is going to stop you from having the birth you want to have, but there are protocalls that we have that you can't get around.
The key is that you have to KNOW what you want, and stick to it. You also need to have a good doc/mw that is pro natural.
I don't work with a single nurse that is going to try to sabotage your birth plan, but they will certainly be pissed that you don't have an epidural. It's much easier for them not to have to listen to you scream and for them to be in the room helping you get through your contraction.
I think hospitals are maybe starting to see the light. Things have been much worse in the past, so if anything, I think they are improving.
Take control of your birth and experience no matter where you birthing!

What do you mean by "protocols that you (the hospital) has that I can't get around"?

And this is where the problem is. Women actually believe that. They are made to believe that certain "hospital policies" are non-negotiable and set in stone and things go downhill from there. In reality, by codified law and precedence set by the Supreme Court and the code of ethics for both hospitals and medical providers, my right to accept and/or refuse treatments is mine and mine alone, and is absolute. Regardless of what administrative practices, protocols, and /or policies the hospitals set, my right to informed consent/refusal takes precedence over all of those.
I see what you are saying & as a Nursing student, CBE, CNA & Birth Doula I definatly agree about how specialized nursing is. however, I feel this is the missing Key, the main point that needs addressed:

During labor, when a woman is most likely to be vulnerable & in need of loving support & encouragement, is NOT the time to be 'having the fight of your life'.

And This is an equally important area for concern.

"most of the distress of newborns comes directly from the overuse and misuse of pitocin and epidural anesthesia" As well as other unnecessary routine medical intervention.

Infant & Maternal mortality rates in this country, as well as vast overuse of surgery for birth speak loudly of the fact that there is a problem with the way this country views birth.

food for thought.
I agree, but where I live there are lots of hospitals that do not give women very many choices. Some hospitals will not let you birth at their facility if you do not agree to a Pitocin drip. And others make you sign a waiver relieving them of responsibility before you are allowed to get up and walk around (thus taking off teh fetal monitor for any lenth of time). And then there are many hospitals around here that do not allow midwives to deliver babies in their facilities. So depending on what part of the country you live in, having a completely natural childbirth in a hospital can be VERY difficult.



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