Provider Member, N.E.W. Birth Options PMA
Research studies have shown that the hospital is not the safest place to give birth for the average, healthy, expecting mother. C-section rates are dangerously high due to the myriad of interventions that take place during labor.
However, about 99% of women who birth in the United States choose to birth in a hospital. Perhaps they feel safe there, perhaps they never gave it much thought and are just doing what they have seen others do, perhaps they have been scared or persuaded by others, or perhaps they just do not know that alternatives to birth exist. Regardless of the reasons that women choose hospital births, I believe it is important that every mother-to-be have an idea of what they can expect from the hospital experience.
I support women in hospitals as a birth doula and love the opportunity I have to work with women prenatally and throughout their labor. We work on education and research all along the way so as each mom has choices to make in her journey she is prepared. She has been given the keys to understanding hospital birth and is informed so that she can make a competent decision and feel confident that it is best for her.
|What to expect during labor|
Hospitals offer assurance to many women that want modern technology and comfort measures, but it is important to keep in mind some of the things that may be out of your control should you choose to labor and birth at a hospital.
|Most hospitals have limitations on things such as eating and drinking during labor, ability to move around, control of the birth environment (i.e. lighting, music, etc.) or the number of people in attendance. Hospital staff will need to monitor your labor progress in agreement with their hospital policies and thus restrict your personal privacy. Some of these limitations may inhibit the natural progression of your labor and if too much time passes, hospital time limits may dictate the need to move things along through the use of artificial means. This means they may want to break your water, or give you Pitocin, or other drugs to increase the speed or strength of your labor.|
You can expect to be monitored by instruments that take your pulse, blood pressure and check the baby's heart tones. Often these mechanisms remain attached as do the IV fluids given so that you do not become dehydrated. This can make it impractical to stay mobile throughout your labor. Expect to listen to the various sounds and alarms associated with these devices. You can request to be monitored only intermittently if hospital policy allows.
Regardless of the length of your labor, you should expect to have turnover in hospital staff. Either because of a shift change or moving from the labor and delivery ward to the hospital stay area, you may encounter a myriad of different nurses and other staff. This could also be true of your doctor. If he or she is part of a group of physicians/OBGYN's, your birth may not be attended by the doctor you were expecting.
During the pushing stages of your delivery you may be coached by one or more nurses to push in a particular pattern. The bottom half of the bed may be dropped down or removed to allow the doctor easy access to your baby’s delivery and special stirrups or leg rests may be pulled out from the bed to support you. Most women in hospitals deliver in this supine, or “on your back” position. This is usually not the most conducive position for pushing as gravity is working against you and added pressure is placed on your sacrum, nor will it feel very natural, but it is usually the position best for the doctor to get a good view of exactly what is happening. Try to relax as much as possible. The less tension your body exhibits the better your labor will progress.
If Pitocin is used to enhance your labor you will likely have stronger, more intense contractions which may lead to a decision for an epidural, or at least the suggestion of one. Interventions such as Pitocin can often lead to interventions which may indicate the need for additional interventions. It's a chain effect. The hospital staff knows that they have the technology and equipment to deal with the potential complications that arise and are thus not worried about the potential chain reaction. It’s just another day at work for them but this is your baby’s birth day and a day you will remember for the rest of your life.
|What to expect once the baby arrives|
Once your baby emerges, you can expect the doctor to cut the baby's cord right away. If you desire delayed cord clamping, make sure that you have discussed this beforehand. It may be advantageous to remind the hospital staff right as the delivery is taking place as it may be instinctive for staff to grab the umbilical scissors immediately.
It is possible your baby will be placed on your stomach for a moment or they may take him directly to the heated lamp to dry him off, measure and weigh him and assess his general health. It is during this general assessment that hospital staff will administer your baby’s vitamin K shot and routine eye ointment. If you have done research on these topics and wish to decline them, you will have to make staff aware of your desires before this time. Again, since these are routine procedures, you may need to remind them of your desires more than once.
|During this assessment the cord will be cut for a second time at a location closer to the umbilicus and dad may be asked to participate. Upon complete assessment of your baby's health, he/she will be swaddled tightly and handed to you to hold. Cord traction may be performed by the doctor to expel the placenta from your body within the first 5-10 minutes after your baby's birth. Your doctor will assess for perennial tears or prepare to suture from an episiotomy that took place as the head crowned. After all repairs are complete, you may have to wait some time or you may be taken to your overnight room right away.
As you are getting settled in your room and are becoming acquainted with the nurses on shift, it is at this time that you will be given lots of hospital paperwork to review and sign with your nurse. During this time it is likely that your baby will spend time in the nursery receiving his/her first bath and having routine tests and procedures performed. Your baby will be brought back to you after some time and nursing can commence.
If you have decided against any of the above procedures you will want to make hospital staff aware of your desires and remind them continually of them. It is not necessarily their intention to disrespect your wishes but sometimes they are so used to their routine that they forget. It will be your job to help keep them on their toes.
You can usually request that your baby room with you. Although you will be quite tired after the busy delivery, it is best for breastfeeding and bonding that your baby always remains with you.
If you had an epidural you may experience certain sensations, or lack thereof, for a while after the birth. This could affect your mobility and you may require help going to the bathroom or even situating yourself comfortably in bed. With an epidural you can also expect some challenges with your baby's ability to latch on for breastfeeding. This is due to certain side effects of the epidural. For more information on side effects of epidurals, please click here.
If you had a cesarean section delivery, expect to remain in the recovery room for quite a while before being taken to your hospital room to settle in. Your baby may or may not be allowed into the recovery room with you. But the two of you will be reunited in your overnight room. Again you can expect to have initial breastfeeding issues due to prolonged separation and side effects of drugs.
As you can see there is a lot to keep in mind when birthing at the hospital, especially if you are seeking a natural birth or if you want some things done differently than what their normal protocols are. This is where hiring a doula to attend your birth is an excellent idea and worth every penny. A doula is not only an expert in understanding the birthing process she will remain constantly aware of your desires and bring those to your attention at the appropriate times. Proactively hiring a breastfeeding counselor or meeting with the hospital lactation consultant may also be a good idea. They, too, are experts in their field and will be able to ensure optimal chance for breastfeeding success.
A Mother's Suggested Supply List for Her Hospital Bag:
Whether planning a hospital birth or not, it is always a good idea to prepare a hospital bag. Below are some suggested items of things you may want to include in your hospital bag:
- Hospital Paperwork
- Insurance Cards
- Photo IDs
- Change for Vending Machines
- Reading Books/Magazines
- Baby Book/Journal
- Friends & Family Phone List
- Phone or Calling Card
- Video Camera
- MP3 Player and Music
- Water Bottle
Items for Dad
Items for Baby
- Receiving/Baby Blanket
- Diaper Bag
- Outfit to Go Home
- Car Seat
Items for Mom
- Nursing Bras
- Nursing Pads
- Nursing Tops
- Underwear (generous size)
- Couple Sets of Clothes
- Shoes to Wear Home
- Body Soap
- Hair Brush
- Hair Ties/Clips
- Nail Clippers
- Throat Lozenges
- Lotions/Massage Oils
- Sanitary Napkins
Also, take a look at the vitamins and herb suggestions offered on our homebirth page. You may find it beneficial to research them prior to your birth.
On a side note: If you have a hospital birth and want to take your placenta home with you to plant a tree, encapsulate, or for whatever reason, you will need to make this desire clear before your birth. Many hospitals have a policy that once the placenta has left the delivery room it cannot be brought back to you. If you are unfamiliar with all of the benefits your placenta has to offer you after your birth, click here.
It is of vital importance that each and every woman plan to give birth in an environment that she feels safe in and with support of the people/professionals that she desires.
Homebirth, hospital birth, birth center birth, midwife attended birth, unattended birth… they are all choices. No one way is right or wrong. It is my belief that choices should be made based on an awareness of available options and on understanding the benefits and risks associated with those choices. I wish you the very best as you discover your birthing options and make the choices that are right for you and your baby.
|For more information about homebirth, click here.
For more information about having the support of a professional doula at your hospital birth, click here.
|"Only with trust, faith, and support can the woman allow the birth experience to enlighten and empower her.
Women's strongest feelings [in terms of their birthings], positive and negative, focus on the way they were treated by their caregivers."|
- Annie Kennedy & Penny Simkin