It totally depends where you choose to give birth and what the protocol is for that specific place. A good friend of mine says "Sign up for a hospital birth, get ready for the hospital ride" when it comes to many things and not wanting to do those things but 'needing' to do them. Don't get me wrong, certain procedures when done for the health of both mama and baby are a wonderful thing, but at least near me there are things done for everyone regardless of need in many situation. Hiring a doula who has had clients before in your particular hospital would be a good first step as well as asking questions to mamas who have been there for births before to see what you can expect as 'normal' for this particular establishment.
You should be allowed to give birth in whatever position you wish. As for eating/drinking, you may not be allowed if your labour is progressing slowly and there's a chance you may need surgical intervention.
You can refuse an IV, but really, if they are giving you an IV its with good reason so I probably wouldn't refuse it.
I had a natural birth with just gas and air with Daisy and the hospital were more than happy to go with my wishes and didn't offer me an epi because my birth plan said I didn't want one.
If you make your wishes very clear you should be okay.
Thanks all! The reason I am wary of the IV is because first of all, my sister straight up told me the IV hurt worse than her delivery, (and she had 2 naturally). You may or may not agree with that, but that was her take. Secondly, it has been mentioned that if you already have the IV, it makes it easier for them to push further medications/interventions on you because the line is already in place. (Obviously not an epidural, but perhaps other meds like Demerol?)
There is a birth center in my city, but they are very selective and only work with very low-risk mothers. With the possibility of twins and my family history, I'm very concerned they won't take me on. That leaves me with two main hospitals, neither one that seems to have a natural-friendly reputation. (And only one that is in-network.)
I'm just feeling very frustrated. Feeling completely out of control of issues that pertain to MY body and MY child. I don't want to have to go into this swinging and fighting, but fear that's what it might come down to. I've even read stories about OBs who have refused to work with women who want to go the natural route. It just disgusts me, and I don't know how to handle it. I'm not, by nature, a confrontational person at all. But this feels like a fight waiting to happen. I guess I need to hire a doula, (an added expense in addition to our other mounting medical bills,) to help advocate for and educate me.
Thanks for all your advice and support! I really do appreciate it!
Find out if any midwives deliver at the hospital you have to deliver at. I delivered my baby without pain medication attended by a midwife in a hospital. I can't say enough great things about my midwife! Like I said before, OBGYN is a surgical specialty. They're trained in intervening in childbirth. I don't think they're all necessarily horrible and refuse to let women deliver naturally, but when you're trained to see problems and offer certain solutions, you're going to see problems and offer those solutions, know what I mean? Midwives are medical professionals too, and will do whatever is best for mama and child including handing your care over to the OBGYN on call if need be, but they have more experience than most OBGYNs in the process of natural childbirth.
I totally agree with hiring a doula. Why do you think you would risk out of a birth center birth? If its too personal to mention (and I obviously am no professional so what I think doesn't really matter,lol), you never know until you ask the staff there and meet with them to see if you really do risk out. There are lots of crazy things on both sides of our family, and I have had 3 out of hospital (home) births and assume I would have been able to do a birth center if I had chosen as well.
You also may be able to find a doula who is working towards her DONA certification and willing to do it for cheaper than a fully certified one, or, a doula who is not certified on paper at all but does have lots of experience. Ask around, google search in your area or ask at the birth centers to see if they know of anyone who will come to your hospital. Word of mouth works as well, and, while my doulas were always free (I am lucky!) they are worth every penny and my biggest recommendation to any pregnant mama who is planning a natural birth in or out of the hospital.
A hospital doesn't mean a horrible birth experience (when I say "experience" know that this obviously does not trump all safety in mind to me) when you have a doula and chosen OB or MW there who you have gotten to know over the last 9 months. Interview withing the practice and see who you jive with the best, although depending on "who is on" when you go into labor, you might not get that person or they might come in special for you. (As did my OB that I had with Bronwen)
And if you want to message me directly, please do. I know birth workers all over the united state and would love to help you find somebody. <3
Many women want to refuse an IV because they want to be able to walk around and move freely during labor, and an IV does hinder that somewhat.
Some hospitals require it, but some will allow a port to be put in but not actually connected to anything (in case you need meds fast in an emergency, the drs don't have to spend time trying to find your veins and get a needle in). If you fight hard enough, you can likely sign a waiver to refuse it, but I'm not sure it'd be worth it.
I think your sister must be confusing an IV with something else. An IV just feels like a normal shot, so not really painful at all (and definitely not worse than labor). My plan was to have a water birth at a birthing center but after three days of labor I wasn't progressing so my midwife took me to the hospital instead. The doctors there were aware that I wanted to do natural if possible so I didn't have an epidural or any other pain meds. The IV had absolutely no effect on this one way or the other. I did end up having to have a c-section which I thought was going to be scary but was actually very quick and painless and after being in labor for so long, I was just happy that my daughter was healthy and finally here.
Originally Posted by tintri
My advice would be to interview a few doctos/midwives in your area and choose whoever you feel most comfortable with. Make sure to tell them specifically what you want to happen with the labor (natural birth, etc) and bring a list of questions/concerns that you have. And no matter what happens, just remember that labor doesn't always go as planned and that you'll need to be flexible.
Tintri, if you'll allow a bit of speculation I wonder if you feel that it's very important to have a "natural" birth (by this I assume you mean pain relief-free and non-managed) because the circumstances which permitted you to conceive were high-tech-- i.e., an operation and a powerful prescription medication? Do you feel that is important to prove that your body isn't "broken"?
Secondly, my advice regarding "documentaries" like the Business of Being Born is to apply the same degree of skepticism as you would to any other person or product claiming to let you in on a vast conspiracy-- especially if that person is an outsider claiming to reveal the secret motivations and machinations of a group of experts (or, even worse, claim that they experts don't really know what they're doing, but that they, the outsider, have figured it all out). Just like it's equally implausible that the US government staged the 9/11 attacks as a pretext to invade Iraq, or that the moon landing was faked, or that Soylent Green is made of people... it's equally ludicrous to presume that there is a vast financially-motivated conspiracy by pharmaceutical companies and ACOG to systemically strip women of their autonomy, subject them to completely unnecessary treatments (including major abdominal surgery), all to get kickbacks & to their golf games on time. [I love the golf game thing-- the poor women who believe all this stuff are so far removed from having any friends in medicine that they don't know 75% of obstetricians are female, and are quite unlikely to play golf].
The other thing I find a bit sad is this belief that obstetricians are black-hearted villains cackling over pots of gold. The same degree of trust and implicit beneficience most people impart to other kinds of doctors for some reason isn't extended to them. I very rarely see a Surgery patient who claims that my recommendation to remove their pancreas is motivated by profit or my sick, perverse desire to strap them to a bed and render them unconscious and helpless, all while snowplowing them with fancy terminology and threatening language. Yet some people really seem to harbor that degree of mistrust re: OBs. As trite as it sounds, they really do have your best interest at heart. They want you to have a boring, normal, uncomplicated pregnancy, a boring labor, and mind-numbingly normal birth. But if that's not the case-- and frequently it is not, alas-- they have the skills, technology and personnel to ensure a good outcome regardless. Pregnancy and labor complications are all perfectly physiological, and in that sense are just as "natural" as endometriosis. I'm sure you understand this in your work as an SLP and can think of multiple analogies regarding brain development, the anatomy of the palate/lips/tongue, etc. All these problems are perfectly natural, and perfectly real.
Thirdly-- it is a complete, utter, and ridiculous falsehood that obstetricians don't know how to "recognize" or "manage" a "natural" labor & birth, and that all they can do is "interventions and surgery." Anyone reading this thread, please stop repeating this absurd and starkly ignorant lie (which was cooked up by self-serving natural childbirth interest groups). By the time an Ob/gyn has finished residency they have attended, on average, 1000 births. [This is in constrast to most nurse-midwifery programs, which require variably 20-40 births, and fake midwives who have no requirements or qualifications at all]. Even granting the US c-section rate of 35%, that would be 650 vaginal births. Given the heterogeneity in women's preferences, a substantial fraction (probably the plurality) will be normal births where no active management or intervention is needed. I know personally, I have delivered about 40 babies, and at least 25 of those were uncomplicated vaginal births with no pain relief (higher than normal due to a large proportion of Native American patients whose cultural beliefs dictate they birth in pain)-- and I'm no OB.
OK, to answer your specific question: you have the same rights as an obstetric patient as you do as any other kind of patient. Informed consent and respect for autonomy are the rules of the road. You can labor in any position you choose; though delivery itself is restricted to positions in which the birth attendant can adequately visualize the birth and act to intervene as necessary (i.e. after the head is delivered, you are told to stop pushing so as to check for a nuchal cord and reduce it if necessary). You will be instructed to change positions if it appears one particular position is compromising oxygen delivery to the baby. Most hospitals provide tubs, shower, birthing balls, squat bars, and nurses to assist your getting into any position which appears profitable. The IV is placed at admission to L&D for reasons outlined above-- nothing even needs to be infused in it (assuming you are GBS-negative). In general the lower down on your arm it's placed, the more painful it can be (i.e. hand IVs hurt a lot, whereas antecubital IVs near the elbow do not-- simply request one higher up); though to compare it to delivery is a bit overblown. You just had an operation a month ago-- how did the IV go?
Most importantly-- no one goes into medicine or nursing to play sick head games with patients re: subjugation and control. You were most recently a surgical patient; did you feel disrespected or forced into an operation you didn't want? It's not like I or any other doctor comes home at the end of a long shift rubbing my hands together gleefully, thinking of how many people whose autonomy I quashed that day. I sense a strong undercurrent of fear in your posts, fear that somehow the mythical "cascade of interventions" is completely unnecessary and just a power struggle which you must mightily defend yourself against. I hope you come to some peace regarding this because I would hate for you or anybody else to spend their pregnancy fretting about doing battle with the medical establishment-- there is enough to worry about as is.
There is not nearly enough space to address all of the self-serving lies, mistruths, and ignorance found in Ricki Lake's movie or most of the other NCB literature, but here are three important facts. 1) For first-time mothers with full-term singleton pregnancies and no medical complications (i.e. no pre-eclampsia, no gestational diabetes, etc), no anatomical complications (i.e. no breech babies)-- in short, low-risk women: the c-section rate in the US is between 13 and 14%. The *total* rate is 35%, but for you, the relevant statistic is 13-14%. 2) Epidural analgesia has been repeatedly proven not to increase the rate of surgical birth, and it increases the length of the first-time mother's labor by an average of 30 minutes (over a total of 24 hours, or 2.5%). 3) Electronic fetal monitors can operate by telemetry, meaning you can walk around the ward, and they work underwater. This means that even if you opt for the safest possible birth, by no means are you "strapped to a bed" full of tubes.
Also I ordered a giant turkey sandwich at hour 34 of my 40-hr labor, which was conducted in my massive high-tech academic hospital. Modern obstetrics practices permit eating and drinking in labor as long as you have an epidural (otherwise you would need to be intubated for general anesthesia in the case of an emergency c-section).
Most importantly of all-- it is your ob/gyn's job to answer any and all questions you have about techniques, policies, reasoning, etc. You are hardly the first woman who had questions raised by Ricki et al. And as many other posters suggested, you might prefer a Nurse-Midwife who operates out of a hospital. Seeing a CNM by no means guarantees a risk-free pregnancy or a vaginal birth, but their care model might appeal to you more.
Thanks everyone! I got in touch with a doula today who seems like a great fit. I really appreciate all your kind words and helpful comments. You all have really helped calm me down from the frenzy I was feeling in my original post!
@blade: Your post made me LOL because you are so right on! Hubby and are so worked up because we've watched these documentaries and have really no other point of view to base our opinions on. So after seeing all them, we felt terrified! But the truth is, my latest lap experience with my OBGYN was a very positive one, and I have absolutely no complaints. So I'm not sure why I'm feeling so tense about trusting her to deliver the baby.... Honestly I think it's because of all the natural birth literature! A lot of NB advocates do make the whole OB profession out to be sinister and lacking compassion for patients. It has skewed my perspective of even my own OB, whom I actually really like and respect. So thank you for the reality check! I definitely needed it to come out of the neurotic head games I've been playing with myself. It doesn't help that I'm not working during summer break and I have too much time to read/watch things that terrify me. Honestly, I need to just discuss what I'm thinking with my OBGYN (who is great BTW,) and see what her thoughts are. Thanks for helping me keep an open mind, Blade! I really appreciate all your insight.