Natural Birth in a Hospital

Soon after being 100% sold on a home-birth or a birthing center, it dawns on me that my insurance (Medi-Cal. Government Aid) does not cover midwives.

It took all night to cry the tears out.

No use in crying anymore. It is what it is. I can't fork down 5,000+ dollars and my insurance is a no-go. Stiff upper lip! You can do this, Susan!

Natural birth in a hospital!

I am blessed enough to have found Dr. Right on my second try.

Yes, he'll allow birthing in a position other than on my back.
Yes, he's pro-unmedicated birth and even admits, "It's much healthier for the baby!"
Yes, he is encouraging me to labor at home until the last minute before my water breaks or I see blood.

I was thrilled to hear all of this! His downside? When I asked about having intermittent only fetal monitoring, he actually mumbled, "I could get sued..." and then quickly replied, "We'll talk about it when the time comes."

What?! No! No! I want to talk about this now! I'd love to be able to walk around during labor or even labor while squatting and I can't do this with wires and tubes up my crotch! .....No, I did not exclaim this. I didn't want to scare him off just yet. That's for the next visit. Better leave it at that for now.

I can't believe I even have to worry about this kind of thing!

Anyone else out there attempting a natural birth in a hospital? Or have been through one before? Is it possible to get through it without pressure and drug offers or being snipped and cut?

Tags: Dr., Right, birth, cry, hospital, insurance, natural, positions, questions, surgery, More…un-medicated, worries, worry

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Permalink Reply by Karen M on February 20, 2010 at 3:42pm

They do, and really your dilation means pretty much nothing. I was 3cm at 3am, 4cm at 5:45am 8cm at 6:30am, 10 at 6:35am and baby was born at 6:47am ! I wanted to be checked though, I was curious, They asked me every time though if they could check me, I could have refused and I wouldnt have been harassed. Maybe you should come deliver in Canada! LOL

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Permalink Reply by Heather Zavala on July 13, 2010 at 11:50pm

Well Susan, you may have had your baby by now and I would love to know how it went. If you haven't I would love to share some of my story. I am a labor and delivery nurse at a fairly busy L & D unit. It is sad to say, but I see a LOT of elective inductions, early epidurals and then, you guessed it primary C-Sections for "fetal intolerance" or "failure to descend"... I became a labor and delivery nurse because I looooove labor and unfortunately current trends are lessening the wonderful process of birthing our children. Love the movie, and am a huge advocate for my patients and staff to do what our bodies were created to do!!!

I have had 3 un-medicated vaginal deliveries in a hospital and they have all been different, but my third was by far my favorite and my ideal hospital natural birth. I arrived at 8 cm and delivered about an hour later after. I had to wait to push so my antibiotics could run-in my IV since I was GBS (group-B strep) positive this pregnancy, but once I got the go light, out my daughter came. It was really a wonderful birth as I was able to do most of my labor at a park, sliding down a slide with my son, eating with the fam, and then laboring on my bed with a little Nora Jones in the background. Once the contractions became quite uncomfortable, I used my tub, in and out and back in, walked around and then I went to the hospital to deliver and within 12 hours I was back home. I honestly could not have asked for a better labor and delivery, except maybe no GBS.

So, it definitely can be done, and while I can only speak for myself and the awesome nurses I work with, we love an un-medicated labor and delivery where mom comes in already in labor and wants to let her body do what it was meant to do. For me it means more time with the mama and less time at my computer trying to stay caught up with all of the charting that inductions, epidurals, and interventions require. Let your support people know your wishes, educate yourself on natural pain management comfort measures (i.e. massage, bath, balls, changing positions, resting...), tell the staff when you get to the hospital and ask them not to offer meds to you, and do as much laboring at home as you can. This is the big one I believe. Do your laboring at home!!! I think that once a person gets into the hospital, their threshold for pain starts to diminish a bit. The reason being, I think we really associate a hospital or medical setting as a place we expect something to be wrong or painful, but this is the beauty of normal and healthy pregnancies and deliveries, NOTHING is wrong! In fact it is very RIGHT and if you know that and your support people know this, then I believe the staff is more apt to support this as well.

Monitoring - it is the bane of our nursing existence at times, but if you are going to labor and deliver in a hospital there will be monitoring. Questions to ask is if the hospital has cordless monitoring, as these can be submerged into water and thus you may still use the baths if you want (highly recommend). And speak to your doctor about how often he or she will want you to be monitored. Many hospitals have standing orders as far as monitoring, but your doctor can choose to modify them to better suit the labor you desire. At our hospital, we like to get a reassuring strip on the baby at least one time an hour (15-20 min) until you are 10 cm and then it is every few minutes usually. This is what we do when no other interventions are being used. Once Pitocin or any cervical ripening agent is used, it is a different story.

So to recap - I think a natural home-like labor and delivery is possible if you can do much of the laboring in your own environment, don't ask to be induced, decline meds or epidurals and advocate for the labor you desire ahead of time to your provider, support people and the hospital.

If you have not already delivered then I hope this helps, if you have then I hope you had an amazing labor and delivery and that you and baby are healthy and happy!!!

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Permalink Reply by Susan Castleman on July 16, 2010 at 5:20pm

Hi Heather!

Wow! How encouraging was your reply! Thank you! I have not delivered, yet. But GOOD NEWS. I found a midwife my insurance would cover as long as it is in the hospital setting. I'll take a midwife in ANY setting!

You gave great tips and good advice. It was really nice of you to take the time to encourage me and to share a bit of your wisdom and nursing expertise.

Good job with all your natural labors! I'll let you know how mine turned out!

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Permalink Reply by Heather Zavala on July 20, 2010 at 2:21pm

May you have an incredible labor and delivery -when you're in the throws of it, remember all the women who have gone before, not only survived, but came away with healthy babies and a great birth story! I will thinking and praying for you :)

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Permalink Reply by Sara on July 20, 2010 at 12:23pm

It is absolutely possible. Remember that you are paying them to provide a service to you. You have the absolute right to informed consent and/or refusal. Which is --you have been explained why they want to do said intervention, the risks of doing it have been explained, alternative procedures and associated risks have been identified and explained, and the risks of doing nothing have been explained. Think of what they ask you to do (even monitoring) as suggestions that you can agree to or decline. Federal, state, and court rulings as well as the AMA all say that your right to informed consent is absolute. Nothing supersedes that. Esp not hospital policy. Certainly not a doctors opinion or standard practice. While you can tell them no they don't have the same luxury ;)

Do your research. Know your information that way they cannot scare you into agreeing to an intervention that is not necessary. Bring literature to you doctor that shows that while monitoring does not prevent or reduce the incidences of fetal trauma/harm/cerebral palsy (which is what it was invented to prevent) it does increase your chances of having a c-sec. (let me know if you cant find this info and I will post links to it). If necessary bring lit with you that explains why you choose to forgo other routine interventions as well. he is more likely to take you seriously if he feels that you have researched this and are making an informed decision not just following some fad or doing what you saw some celebrity did.

Be willing to sign (or print up and sign and bring with you) papers explaining that while you have been recommended a certain intervention you and have been explained the risks involved and why the recommendation was made you choose to decline that procedure and will hold harmless the dr and hospital. Basically that you are practicing your right to informed consent/refusal. That way he can't be worried about being sued.

Check out www.ican-online.com for basic rights. Check out AMA website http://www.ama-assn.org/ama/pub/physician-resources/legal-topics/pa... to read about informed consent. Google EMTALA to find out your rights to get treatment in the hospital. Good Luck!

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Permalink Reply by CAROLINE GOURLEY on July 22, 2010 at 7:43am

I agree with this advice from Cherylyn:

"Why does your doctor think he'll get sued if he doesn't do continually monitoring? Does he think YOU are going to sue him? You can talk with him calmly about how you've done your homework and you know that intermittent monitoring is just as safe, if not safer, than continuous monitoring, and you will not be suing him for any reason. It's important to have the conversation now, before you're in labor."

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Permalink Reply by Kelly Huljev on September 17, 2010 at 10:04am

hi susan! i am going through the exact same situation...although, i have yet to find a midwife who accepts Medi-Cal. do you mind me asking the name of the midwife?

thanks!