the stomach for hospital birth
spamelita on Aug 11 2007 at 9:08 pm | Filed under: midwife practice, political, ranty
I have to say that I’m always fully supportive of women to make their own, informed choices. I just need to point out that I am grateful - eternally, blissfully grateful - that my view of birth is vastly different than what is seen in the hospital. Even in “normal” hospital births.
Barb Herrera once made an entry called “You Buy the Hospital Ticket, You Go For the Hospital Ride”. Read this, please - even if you’re not planning a hospital birth.
As a midwife there are times when I am involved in hospital birth. Not as a provider, per se - but often as a stunned observer. Sometimes I’m asked to go as “support” and other times I’m there because we have transported a client there in labor for various reasons. If you think that being a midwife (or even hiring a doula) can somehow make all the hospital crap go away, you’re in a for a shocking (and painful) surprise.
The busy-ness of hospital birth is what is most astounding to me: all the monitor gazing that goes on - all the concern about “pain scales” - all the charting. In a half an hour, a nurse talks to the patient less than five minutes. The other 25 minutes are spent doing loads of paperwork and charting. It’s no wonder that there are continuous fetal monitoring, automatic blood pressure cuffs - even a new device that you can insert into the cervix/uterus and it will monitor dilation automatically (see http://www.femsuite.com/ - look under “FemGauge”). Heck, everything is done for the nurse because they are likely overstaffed, overworked and have way too many patients at one time to care for. What L&D nurses do today is a far cry from actual “supporting” pregnant and laboring women. They are working at making sure everything is well documented in case of litigation.
It is a rare woman that starts her labor on her own. Many women receive ultrasounds at the end of pregnancy (a time which ultrasound measurement for dates can be off by as much as three weeks - never mind that she knows when her last menstrual period was!) that move her due date earlier. Induction talk begins at around 37 weeks, with weekly vaginal exams and measurement of “progress”; “ripening”; “feasibility that you’ll go into labor on your own“. Small seeds are planted in the woman’s head, readying her for the “necessary induction” once she gets to her due date or days past. If that doesn’t work, the ultrasound can inaccurately measure the “big baby” and that can scare her into allowing an induction. (Even though we know that in the last six weeks babies gain, on average, a quarter of a pound a week - and slow at or after the due date in gain. Ultrasound estimates are typically off as much as two to three pounds at the end of pregnancy for “weight estimates”.)
Because induction is typically done on an unripe cervix (because the body isn’t ready), women are admitted the night before for “cervical ripening”. Prostaglandin gel (made from pig semen) is inserted into the woman, hoping to soften and possibly thin out her cervix a bit, making induction in the morning more “successful”. Sometimes this step is bypassed altogether and Cytotec (misoprostal) is used instead. Cheap and effective even on “unripe” cervices, Cytotec is a risky, dangerous drug that once in cannot be turned off like Pitocin. Rupture of membranes is another method to further induce labor.
Women rarely have hospital births without an IV. They are attached to the two belts of the external fetal monitor (which makes the monitor like a TV: something that even untrained bystanders cannot help but watch mesmerized constantly….“oh, that was a big contraction!”, never even looking at the woman at all). These belts are uncomfortable - two tight bands against a uterus that is contracting. Women are likely in bed nearly all of the time. If you happen to be a larger mom, being on the birth ball (if you’re fortunate to have a hospital with a few of those “hanging around”) or other positions not on the bed could make picking up heart tones an issue. If that is the case, an internal monitor (“just a little screw that goes into your baby’s scalp - they don’t even feel it really!!!”) is placed, along with an internal uterine pressure catheter (IUPC) inside your uterus to monitor the intensity and frequency of your contractions. Both of these leads into your uterus mean a higher rate of infection…it’s like a bacteria superhighway right into your baby’s home. Bacteria you are NOT familiar with….bacteria from a hospital that has other illnesses present. They mop the ICU floor, another woman’s labor room floor, they mop your floor. The floors are sticky, gross. Don’t EVER sit on or touch a hospital floor.
Can I tell you how uncomfortable watching “perineal massage” during birth makes me?? Why do we still think this is helpful? It’s so obvious from a biological, physiological standpoint that it’s not! (“Oh, Dr Jones is sooo progressive….he will help stretch your vagina with warm mineral oil to keep you from tearing!” How about just keeping your hands out of my ladybits altogether? Better yet, I’ll birth in a position - upright no less! - that will keep you from messing with me!)
(You might be able to have a drug-free or epidural-free hospital birth, but the way they treat your baby is NOT humane or physiological. A baby should be in its mothers arms for at least an hour before it is taken for “procedures”. This is rarely, rarely the case. In my eyes, it’s how your baby is treated after the birth that astounds me. That THIS is somehow ok with new mothers.)
I have actually seen this scene replayed more times than I can count. Anytime I’ve witnessed a vaginal birth in the hospital, the actors and the scenario is very similar. Even when it was MY client as a midwife. Only in one instance did I find my client - a deaf woman no less - yelling at the doctor that “YOU WILL NOT CUT ME!!!”. I found myself feeling stunned and almost voiceless against these actors. Some would look at me, pointing to the perineum saying, “see how the perineum is blanching here? See this? She’s going to tear bad if I don’t cut!” Get your fingers out of there and stop stretching her to that point!
I have seen many, many births like this in the hospital. It’s not unusual. I know there are some births where the woman walks in and boom! The baby is out before labs are drawn or an IV is placed. Maybe she’ll get lucky and not have to birth on the bed. Frankly, these births are rare.
It’s why, as a doula, I had to stop doing hospital births. After being immersed in home birth, I couldn’t get over the fear, the anxiety, the meddling, the complete disempowerment of hospital birth. I mean, if I need to be in a hospital for birth, that’s one thing - then I’m there to take whatever skills and medicine they have. However, for NORMAL, NATURAL birth, a hospital is not equipped or even interested in giving anyone that.
I’m not talking natural vs medicated. I’m talking unhindered vs interfered-with birth. I’m talking about barely making it out without being cut one way or another. About your baby being handled roughly. About silence and intimacy not being a piece of your baby’s birth. There are even some homebirth midwives that don’t get the idea of unhindered birth. Really, it’s my new platform. It’s the reason why I’m so angry. We can’t keep bringing the hospital into the home! We have to do this radically different - ways that honor a woman’s physiological process of birth. We have to step back and ask if we’re doing things to really help a mamababy or are we just doing things to cover our ass in case we’re looked at by someone? Is this evidence-based or are we doing it because it’s what our peers believe is necessary?
There are exceptions. To think that you’ll naturally be an exception because you took a birth class or because you have a doula or because your OB is “supportive” of your birth plan is not going to get you far. Most women have to adjust their feelings after a hard hospital birth - it’s their body’s fault, not the system they were birthing in. “I didn’t dilate fast enough”; “The baby wasn’t doing well”; “I couldn’t start labor on my own”; “My pelvis was too small”. It’s how you reason the choice that you willingly walked into. Of course the blame is on you - to see anything different would shake things up too much. (Of course, providers don’t help much in this department, often casting blame on the woman for issues in birth)
I praise those nurses who work in that environment. I’m glad they’re there. I also know why birth can be so scary for those who work in the hospital birth field. Hell, even when I’m there as a witness, I can get scared. I guess I’ve just been so blindly going about my time seeing these beautiful, intimate, unhindered births….the contrast was so glaring and violent. I don’t even understand how doulas can do this work, really. Are nurses really satisfied with what they’re made to do? Made to witness? Are they there trying against all odds to make a difference? Are doulas there to protect the mom from the constant barrage of assaults? Just for one-on-one support? To be in her face through contractions and hope that it makes a difference? To bring a bit of emotional and physical touch to an environment that is set up against those two things?
I can’t even say that having a doula in the hospital will help women. Sure, it’s better than being alone, or with a scared-out-of-your-wits partner. Many doulas know how to work the system of the hospital well. They’ve befriended the nurses and doctors and they’re no longer a threat so there’s more give in their ideas. But really, if you’re hiring a doula to help keep you from having a cesarean, well, let me tell you this: you are giving birth in the wrong place. Think about WHY you need to have someone to protect you at your birth. Isn’t this counterintuitive to the physiology of birth? What have we (they) created??
Birth in the hospital is going to get much uglier before it could even get better. Even then, I’m not sure what “better” is. When we reach a 95% cesarean rate, “better” could look like a 70% cesarean rate. Soon we will have women walking around with the feeling that their bodies are “not designed” for vaginal birth, not to mention birth without drugs or serious interventions.
Birth in the hospital is set up to hurry things along, create serious issues with you or your baby and then have the ability/equipment to heroically come in and save you and your baby at the last minute. You’re grateful that you were in the hospital, after all, or your baby - or you - could have died.
Women cannot be duped anymore. Why are we? I know smart, intelligent, educated women birthing in the one place that goes against what their bodies were physiologically designed to do. They assume that they will be the exception rather than the rule. For those women, I cross my fingers - because luck is all it has to do with..not birth plans, not doctors, not doulas.
Above all, I just don’t understand why we feel like THIS is normal birth and somehow homebirth is the “scary” choice.
Hospital birth is so chaotic and jarring. Right now I’m reading “Pushed: The Painful Truth about Childbirth and Modern Maternity Care” by Jennifer Block. It’s an amazing book. I got the title from Rixa’s blog.
I’m nervous about starting my graduate program and somehow becoming a part of this messed up medical system. I really envision myself working in either a birth center…or on a reservation (I’ve got a lot of Cherokee heritage.)
Pamela, you are AMAZING!!!!
I read parts of that to Ryan and he was HORRIFIED at the thought of a hospital birth. I read EVERY blog entry, and every time, I feel more and more ELATED to know you and more SAFE to have a homebirth with you (when we FINALLY get pregnant ahhhh, I’m going bonkerz). I can’t imagine how hard it was for you to witness that and I’m glad that she had you there to lean on.
Thank you!!!!
I’m an unnecessary caesarean survivor. I well know the trauma of being a pregnant woman subject to the medical environment. Every day I swear to myself that I will never again set foot in that hospital and every day my heart races when I think of the complications that could potentially place me back in that environment.
I am training as a doula in the hope of helping other women avoid what I went through - what countless women go through every day.
The story you told in this post is rape. When is the medical establishment going to wake up and see this? When is someone going to sue their butts for placing fingers inside her vagina WITHOUT HER PERMISSION?
I just don’t get it.
Sage,
I’m blown away by this passage. I always feel at a loss as to how to express what hospital birth (as an L&D nurse)was like for me. You nailed it. Being a homebirth mom and L&D nurse was crazy-making. The two worlds did not mesh, and as hard as I tried, I couldn’t justify what I was compelled to do to women in hospital birth. People always told me, “I’m so glad you are there for those women in the hospital” or “they are so lucky to have you there” but the truth is, the sad, pathetic, ugly truth is, I couldn’t help them. I could only bear witness to their violation and be a part of the problem. In many ways, my book is my atonement.
Hospital birth is not always like this. Unfortunately it is more the norm than the exception…but there are exceptions. And as I continue to develop my art, I plan to make lots and lots of exceptions since I will be stuck in a hospital for the time being. I was a little put off by the post as I got the sense that you felt negative about CNMs. I am a CNM. It’s not a bad thing. I’m not a medwife (although I know they do exist). I worry that the negativity may turn women off to CNMs, when there are many who truly believe in midwifery.
It’s fear that drives hospital births to be the way they are….fear of litigation, fear of lawsuits, fear of “bad babies” and bad outcomes. It’s become far to aggressive to be considered “defensive” medicine and nursing care anymore.
Please believe, there are nurses out there who work the hospital system who FIGHT it, who HATE the violence of a hospital birth, and who try to make it less of such a traumatic experience.
Like Barb said, you buy the hospital ticket, you buy the whole hospital experience.
I recently wrote a post on how to have a natural birth in a hospital setting.
I just attended a hospital birth early this morning with my “Dr. Wonderful”… the first hands and knees delivery I had ever seen in a hospital in almost 25 years. There were absolutely great things, but still, his hands needed to stay off her perineum - I hope to teach him that (will he listen?) - his women continually tear, whereas my clients rarely tear and the difference is I keep my hands off their perineums. He needs to know this piece of information. (They all should!)
I know how sickening it is to watch what you watched, Pamela. It is so, so hard. I’m so sorry for you, but I also know your client’s birth was so much better because you were there. (I like to believe that about my being there, anyway.) Justifications… what is the reason for her having to be there? Her destiny? So, so hard to say.
Thank you for sharing your story. Her story. The herstory. We need to share so many more of these stories. I agree. How can these be the normal stories and homebirth be the scary ones?
Baffling.
I enjoy reading your blog! I can really relate to this entry, too.
I had a hospital birth with a CNM last year. She was very caring, kind, and compassionate, but it was still a painful and difficult birth. I had a doula, who helped as best she could. Despite all that, the nurse forced me to get out of the tub and lay on the bed to push. (They threatened me when I refused.) My baby was face up, and when she didn’t come down after fifteen minutes of squatting and pushing on the bed, they made me lay flat on my back. I had to push for two hours after that–I think if I hadn’t of had a CNM I would have probably been forced into a c-section. The midwife did perineal stretching on me too, and I remember it hurting worse than anything but when I asked her to stop she told me it would keep me from tearing. I had one tiny tear at the bottom that I refused stitches for, it was healed in a matter of days, and two burns or small rips on the top that hurt for weeks. Then the midwife tugged on my cord and I couldn’t stop bleeding, despite us asking her to wait. I still don’t know why she did that. The worst part was how the hospital took my baby every 3 hours to “observe her” even though she was perfect, and then they would kept her for two hours each time and gave her pacifiers and bottles against my specific requests. When I asked for breastfeeding help they sent in the nurse with a huge amount of formula.
I think it’s safe to say I will never be setting foot in a hospital again to give birth unless it’s a life or death situation…The thing that throws most people off is idea that it seems like you can have a “nice” and “natural” birth in a hospital setting–no drugs, a birth plan, fancy hospital suits–but once you look back at all the details and remember how powerless, and belittled you felt you realize that it’s just not true.
It’s so funny; although I was tempted to blame my doula for what happened during my coerced induction/labor/c/sec–I know how helpless she was. We both were.
In sports, there is a definite psychological edge in having the “home field advantage.” This isn’t even up for debate is it? It matters during birth, too; your home, your rules tend to prevail. At the hospital, hospital rules tend to prevail.
More and more I am coming to see and hate the ways women are taught to blame ourselves for the injustices that happen to us. A rape victim blames herself for wearing a skirt. A birth-abused mother blames herself for not being all-knowing, or strong enough, or for being confused, afraid, manipulated.
We have to reject this brainwashing, and demand that our pain be acknowledged, and our autonomy respected. But it’s a hard road.
Kem,
You said, “When is someone going to sue their butts for placing fingers inside her vagina WITHOUT HER PERMISSION?”
I would love to sue, however, keep in mind that what happened to this woman, and to many women every day in hospital births is the standard of care. Hundreds of OB’s and CNM’s could be brought in to testify on perinium massage and episiotomies and how “necessary” they are. What exactly would you sue for? Assault means that the person intended to do harm to another. No woman would ever win on assault charges against a care provider. So on what charges can women sue?
Jennifer - Of course you’re absolutely right. It just seems like such a criminal act to me and there’s no way any of them would ever be charged… It’s maddening. I know of a woman who was coerced into an epidural (read: threatened with being strapped down) then, when she refused having her waters broken, the doc did it anyway because she had no control of her lower body. Rape, any way you slice it.
Maddening.
How terrible, Pamela!!
No matter what some may say, or try to convince themselves of, the world of hospital birth is just that–a universe of its own. Where rape and all the other thinge we would find unconscionable on the outside, are all accepted begrudgingly, silently, dutifully, as “HOW IT IS”.
You are going to get all kinds of comments on this entry, ones from cnm’s who say they are offended. Ones from moms who will say “i had a hospital birth and it was really nice”. Ones from homebirthers who say AMEN, and so on…
But what you are doing is what is so necessary. Reportying and telling and telling and telling what is true and what is fact and what really happened a few days ago, and what is happening today and what will happen tomorrow to our sisters and our friends and our daughters.
Who is to blame?
I have been exploring this lately on my own blog, to VERY mixed responses, and I say that right now the blame game is as useless as ever.
What you were witness to and part of was horrible. As much as women who are birthing in hospitals need someone like you with them, I know I could never be a doula. I get teary eyed when I drive by the 3 hospitals of my own torture–I actually dont like to look at them and try not to even drive past them even though one is very near my home. Like a giant haunted mansion on a hill, therein lies my perpetrators and all my hopes turned so –different.
The Mamas enter into the hospital, I like to envision, on a conveyorbelt, and then they tumble down down down like little tic-tacs, falling down into the cogs of the machinery.
Scary ugly rude sad.
Im sorry you and the mamababy went through this. this sounds just liek the kind of birth my (old) friends would have meant when they said “DIDJA HAVE THE BABY NATURAL?”
sigh and hugs.
homebirth is SO different.
This is why I do what I do! So many women have lousy experiences, or think that they “have” to have the monitoring, the episiotomy, the perineal stretching, the pushing on the back…that those things are keeping them safe, that the mother might have to suffer but it’s all to have a healthy baby. Ugh.
I toy with the idea of becoming a midwife on and off, and I even apprenticed for a while. I don’t think I want to go back to being a doula, especially for hospital births. I cannot be a participant, however passive and unwilling, of the procedures done to mother and baby in the name of safety or routine.
As hard as it was for me to read that, it had to have been 1000 times harder to witness it, and 1000 times harder to be the one having it done to her.
Love you. I know it’s hard, but I’m so glad you’re continuing to speak out. Too few people do.
What is really going to change all of this is a power shift, a human movement, a goddess rising.
Women must demand a better way, educate themselves, look into the face of death, support each other, birth their babies into this world themselves…and NOT be afraid. We must tell our stories, tell our daughters, hold the space for our grandchildren to enter this world in love and peace and joy!
I belive that we are born into this world with an innate knowing, an understanding, a relationship with the universe. We must hold tight to this knowledge and not be coerced into “going along” following the heard, being a “good girl.”
We hold the power of all creation, it is our job as Mama to ensure that our babes get thier birthright to be born how they choose, in grace.
Love to you. I have been there in many ways.
Sigh. As a hospital birth attendant, recently I am more and more discouraged by the state of hospital birth. Don’t get me wrong, I have attended some beautiful hospital births - births with no exams, births where baby was never touched, or rubbed roughly, or made to cry, births where mama was free to move any way she wanted, births on hands and knees, births in full squat, births on the floor, one birth with mama on the floor and me under the bed! In many ways my hospital has a “good” birth culture - the nurses are respectful, my OB backup is very non-intrusive, we don’t have unreasonable policies or standing orders.
And yet, still, I feel the jarring intrusiveness of much of what we do. Also, I think it’s vitally important that even those necessary interventions, those times when you are birthing in hospital because you need something they have, do not turn into an excuse to override the autonomy of the birthing woman. It is not okay to do something without consent, to roughly handle mother and baby, to ignore the express wishes of a woman (such as one who is shouting “No! Stop it, that hurts!”) ever - no matter what the medical situation.
I’m getting discouraged, too, because it is not just hospital culture, but societal culture as you mention. The rumor mill about me in our small town is pretty funny - the doctor who doesn’t like epidurals, who doesn’t even change into “sterile scrubs,” who won’t cut an episiotomy but “just let’s you tear!” I have so few clients who want anything other than to buy the hospital ticket and go for the hospital ride. It is so discouraging to me to see what women will accept as normal necessary to birth a baby.
So much seems culturally insurmountable, and I see my independence being eroded - more and more insurance companies, hospital accrediting agencies, and our regional perinatal network are dictating our hospital policies. It is getting harder to practice against the flow and not get sanctioned for it in peer review and in mandatory review by our perinatal network. It is even harder when my clients are not driving my practice style - they are not demanding a less interventive style of care, I am encouraging them to have a less interventive style of care, and as such, if anything goes wrong it is all my fault.
Sometimes I feel I should give up doing births altogether, and sometimes I feel that if I quit, what would happen to the women I care for - who would attend my teenagers, who do things so unconventionally, but are so rewarding to attend because they haven’t been ingrained yet in the standard American way of birth and so feel free to yell, dance, move, and frequently birth out of the bed.
What can all of us, or any of us be doing to change this cultural view of birth? As a homebirth provider, what do you feel would help change this cultural perception of birth, and then, change the reality of the unnaturalness of hospital birth in the United States?
This strongly reminds me of a conversation I had a while ago with a woman who works as a nurse in Labor and Delivery. Her condescension and lack of respect towards mothers in general, and particularly towards mothers who want to do it “naturally” was appalling. She even told me that if a laboring mother comes into her hospital with a written birth plan, the nurses immediately start putting together the c-section papers. Her reasoning was that it is just Murphy’s Law. Whatever!
I was horrified, and vowed I would not step foot in a hospital to have a baby ever again unless it truly was a life or death situation. How can people be so callous, so power-hungry, as to think that this is okay? Coercion and abuse is never okay, and certainly not at the very beginning of a person’s life.
Arrrgggggh! I could keep going, but what’s the point?
Unfortunately my homebirth midwife was for some reason possessed to try that “stretching” maneuver too. I actually screamed in pain and begged for her to stop and she was just like, eh, gotta do what you gotta do. I am still not sure what it was supposed to accomplish, but it hurt worse than actually pushing the baby’s head out.
I think she was convinced it was going to be a shoulder dystocia, actually. It definitely was not.
This has been on my mind a lot lately. I’m a doula and I’m torn between attending only homebirths and attending hospital births, where I feel I’m needed even more to counteract the effects of the standard hospital interventions.
I recently attended the hospital birth of a mom who had a birth that was about as close to a homebirth as you can get in the hospital. Mom pushed on hands & knees, had no monitoring, no hospital gown, no IV, no coached pushing, nobody was even in the room with us until the baby was ready to crown. But she was treated HORRIBLY by the doctor for refusing to consent to these things and he was downright negligent in his care (refusing to catch the baby, did not wait for placenta, did not check for tears, etc.) It just further proves the point that you CAN’T have a homebirth in the hospital.
“How about just keeping your hands out of my pussy?”
Hell yea - sistah!
I have to say though, that seeing that bothers me so much more intensely when I see it at home. When I see it in the hospital I’m almost prepared for it, ready for it. When I see it at home, done by a homebirth midwife…it’s more than i can take. I was at one homebirth this year where the mom reached down to place her hand against her clit while pushing, and her midwife actually slapped her hand away and said “Stop that - or your clit will tear”. Of course, this team also flicked babies feet HARD to get him crying when they thought he was a bit gunky after birth.
Sigh.
It’s a hard road we’ve all chosen, isn’t it? But I have to believe, I do believe, that we - no matter what role we take (doula, midwife, cbe, activist) make a difference. In some small way, we make a difference.
Jeanette
PS: Have to hunt down your email - have much I”d like to discuss with you.
Check out NM’s new post…such hope in that one! If only, if only, if only there were more of “him”…
http://observantmidwife.blogspot.com/2007/08/birth-unfolds-in-photos-words.html
This is why I had an unassisted birth. Do what you want, when you want, how you want, and with whomever you please! I’ll be having another one in the future.
I am 27, newly married, a nanny for 4 beautiful children and the most amazing parents…never had a baby, but looking into becoming a post-labor doula. I would do the labor doula thing, but didn’t feel comfortable trying to support a family through something that I have never experienced myself.
But I want to learn so much before I embark on such a serious task. 
My husband is actually the one who recommended I look into the doula profession. In his words, “You would be amazing..a blessing to other women.” Thank you for your kind words sweetheart.
I love the idea of empowering women (especially those in their 20’s and 30’s) in this beautiful process. And helping them to find and believe in their God-given talents at motherhood. However it may look for each woman…
I just registered with the DONA and am going through the reading list they supply. I was sent to this blog through a doula acquantience and have enjoyed reading from a new perspective. I had NO IDEA there was such a rift in the hospital and doula world. I had NO CLUE women were being forced into positions they never wanted to go….
I have been chatting with the mother of the girl’s I watch. All four were hospital births. She has said each one was perfect and a great experience. I have a few friends who have given birth and not complained at all….
I was a c-section baby because I was “too big”, and therefore my sister was too. My mother still struggles with feelings of inadequacy, like she “didn’t really give birth”. So sad. That a woman can spend 9 whole months housing a tiny little person, go through the gruely process of birth, raise me up till I was 18, and not believe she is good enough.
All that said, I have been reading through these comments, and I am curious (and slightly confused)…is it really that bad? Is it really the hospitals? Or is it the doctors? It feels like such a strong negative reaction..no positivity towards an advancing science world….I don’t know. I guess I’m just looking for more conversation.
I’d love to hear what you all have to say….
Thank you.
I do believe different regions bring different things. I am also a CNM and our hospital births are nothing that you mention.
Yes I induce but only after the risks and benifits are completely informed to the parents and we meet a mutual aggreement. I have sent home several failed inductions. I do not typically AROM until transition ( give in to hospital politic… needing to know if there is MSF meconium stained fluid)
My hospital has large jaccuzzi bath tubs in each room.. I don’t do water births but do labor in the tub. Women have hep locks which are placed when they get their labs but no IV fluids. There is also telemetry monitoring so if we do a induciton they can be up and walking on the pitocin
Yes I have seen some of the stuff you have mentioned but it also matters where and which home you labor.
I have cut 2 episiotomies in my 15 months of practice and only one as a student.
I do occassionally do some perineal massage but not when the head starts crowning…. i also do not let people count or tell the women how to push when they are crowning…. the body knows what to do and if allowed I WON’T have to sew…. I hate sewing.
So don’t be so critical on hospital deliveries cuz not all of them are the way you discribe
Really, this post is about hospital birth where the woman is induced. I was induced due to pre-eclampsia, and I don’t deny that my experience was very similar (although my CNM barely had time to check me before I pushed, let alone did she have time to move or cut anything).
I can’t believe what you said - and what at least one commenter said - about how you had to stop being a doula in hospitals because you didn’t want to participate in hospital births. The fact that hospital births can be like you describe is the most important reason to be a doula who attends hospital births. Imagine what it would be like for women if no doulas would set foot in a hospital. Who is going to educate and advocate? Women will NOT stop having babies in hospitals anytime soon, and someone needs to step in and support and protect them.
I went into a natural labour with my blood pressure climbing. I had a great midwife who fought for me to have a natural birth. People were scared though and how can I blame them. When things go wrong they can go wrong quickly. Just before I started pushing I became hyperreflexive. There was no warning. I developed a sixth nerve palsy as a result of the blood pressure spiking.
My first birth had been perfect. Home labour, I arrived at the hospital fully dialated. I had been unable to get a midwife for my first birth as I was scared and wanted to be at a hospital.
Reading all of these comments is so intereting. Evidentally even a homebirth does not guarantee a good experience. While I think unassisted birth would be wonderful if everything went well my experience is that you never know what can happen.
My first birth was strictly by Women’s Hospital policy and was far more “natural” than my midwife assisted second birth.
Life, and births, are full of surprises.
Those of us who birth unassisted take responsibility for what goes on at our births. We are the advocates. We say when to push, if we’ll transfer, and also accept that IF something “bad” happens–if we lose a baby, etc–that we still did what we believed was best for us and our babies. It’s not about having the perfect experience or outcome. Birth is about doing your best, being your own advocate, and being INFORMED, truly informed. That’s why most UC’ers don’t birth in the hospital or choose a midwife–because they feel well informed and that UC is the best choice for THEM. It’s about bringing your baby into the world the best way you know how. Babies die in the hospital too, and also with midwives. Anyone who feels they’re mentally, emotionally, and spiritually ready for a UC can and should be able to have one. For those who aren’t, that’s fine. But approaching UC or anything else with fear is like asking something to go wrong. I only say this because the previous comment sounded fearful.
I appreciate what you wrote, but at the same time frustrated that you see hospital birth and natural or unhindered birth as so completely incompatible. For many women, they do not have a choice whether or not to be in the hospital. I have had complicated pregnancies and delievered my sons prematurely. I was too high-risk to deliver out of the hospital setting.
What I want to get across is that there are some midwives, nurses, and even obs who do go out of their way to make birth in a hospital setting as natural and beautiful as possible. This was not the case with my first birth. Despite the doula, we were bullied into most of the interventions you described in your post.
But with my second, we had a lovely experience. Yes, we had to fill out a lot of paperwork and jump through a lot of hoops, but with the support of an experienced CNM, my son’s birth was amazing. The midwife encouraged me to wait as long as possible to check in to the hospital and then was with me through my entire labor. She taped paper over the lights so it was dark in the bathtub. She played music, brought balls and bean bags and other things to help me get comfortable, let me eat (and puke), let me walk, sleep, dance. She checked me once and then caught our baby without gloves as he almost landed in the toilet. Was it perfect? No. We had to fight battles with the neonatologists, especially after our son was born. But when you have such a negative attitude about hospital birth in general, I feel like it leaves many women stuck. Not everyone can pick a birth center or home birth and for those of us who must make the best of a hospital birth, the right hospital and the right provider can make a world of difference.