Labor and delivery issues

[Leanna]

So I'd like this delivery to be both comfortable for me, as well as helping our breastfeeding relationship, so I have a silly little "wish list" for this birth.

I was wondering if anyone has gotten their hospital to LISTEN to you on the following items:

I'd like to be able to nurse right away -- meaning before they weigh or measure the baby and even while the cord is still attached and I haven't birthed the placenta (only if the cord is long enough though, but the point is that I want to breastfeed sooner rather than later)

I've read that not clamping and cutting the cord until it stops pulsating, or at least not *right away* helps with preventing jaundice because the baby gets the last bit of the blood from it. So I would like to wait at least a bit, and not jump right to cutting the cord.

I don't want an IV, its distracting and I do not need it.

I want to be able to snack during labor.

 

[jgonz]

I got those things that you mentioned. It's the Doctor you need to work with and convince, not the hospital. The hospital has certain policies and regulations, However, the Doctor can override those things if he/she so chooses.

Writing up a birth plan with your wishes and going over it with your doctor is the Best way to find out if he/she is going to be willing to work with you or not. I know one mom who changed caregivers in her 36th week because her doctor kept putting her off, and when she finally pressed him to go over her birth plan he nixed everything. She left his practice and found a midwife.

 

[katelyn]

Yes, make a birth plan and get them to through it with you and sign it. This tool is very helpful:

http://www.babycenter.com/calculators/birthplan/

Since you are seeing midwives, I doubt most/any of this will be an issue.

 

[Linnis]

I already talked to my doctor about the IV. We've decided Unless I need antibiotics, food or I decide I need pain meds. I will have the IV thingie in my arm ready to go but no IV tubing or bag attached to it. That way it's ready and there but it's not hindering the birthing process.

This is our half way agreement to the IV issue.

My nurse told me unless there is something majorly wrong with me the kid or I get the epi, even if the nurses say stay in bed, I don't have to listen to them. I can walk laps or whatever in my room all I want.

 

[Leanna]

So I hear there's some issue in Illinois where you are not allowed to eat food....

 

[Naomi4Christ]

I'd like to be able to nurse right away -- meaning before they weigh or measure the baby and even while the cord is still attached and I haven't birthed the placenta (only if the cord is long enough though, but the point is that I want to breastfeed sooner rather than later)

Yes, I did this - no problem.

I've read that not clamping and cutting the cord until it stops pulsating, or at least not *right away* helps with preventing jaundice because the baby gets the last bit of the blood from it. So I would like to wait at least a bit, and not jump right to cutting the cord.

I had natural third stages with my UK births, and asked for it in my US birth. They said it would be no problem, but when it came to it, they used CCT (without ergometrine!!!). It was really the only thing I wasn't happy with so I didn't say anything. At that point, I was more interested in keeping the ointment out of DDs eyes. Midwives, ime, are rather anxious if the cord isn't clamped immediately, so expect them to be hovering over you until the cord stops pulsating and any risk of haemorrhage is past.

I don't want an IV, its distracting and I do not need it.

They don't do routine IVs in the UK. In my US birth, I asked not to have one and they respected it. When I saw the OB early in pregnancy, he told me I would have to have one and I told him that I would not be having one and that was that.

I want to be able to snack during labor.

This wasn't an issue for me as I have quick labours and the food tends to go in the other direction . It is important to have something to eat early in labour though, so make sure you do when you are still at home. If you want to be sure of snacking in labour, take your own food with you. Sweet (with real sugar) drinks are good too.

The other things I put on my US birthplan were no vaginal examinations, no continuous monitoring, hands off my legs, and that I wanted to wear my own clothes. I knew that they were fine about mobility and birth positions, otherwise I would have added those too.

 

[RooMama]

So I hear there's some issue in Illinois where you are not allowed to eat food....

I'm in Illinois. I think it varies by doctor. I wasn't allowed to eat with my first, but I'm pretty sure it was because my water had broken. PROM leads to more intervention, due to the increased risk factors.

 

[RoseofLima]

Here's my approach-- forget them! It's my body, my baby- and I am their customer. I PAY them...they will do what I want. Period. Nobody is going to rip food out of your hands or kick you out of the hospital while you're in labor...so just eat if you're hungry. Walk around if you want, refuse whatever you want.

The things in regard to the baby right after birth- you will need to be clear up front with with your care provider. A conversation where you say "I want to hold the baby right away. I want you to wait to cut the cord. I want to hold off on weighing and measuring. Of course if there are health concerns- they take precedence over these desires."

I don't do birth plans- they are in no way a legally binding contract. They can be helpful, but I find not as helpful as just communicating what you want. I think it is key- that your husband ( or another chosen support person) know intimately your desires and have the tenacity to advocate for you if those desires are being compromised. This is where I think those birth plan tools are really helpful--to sit down and think through your labor- and to communicate what you want with the people who will be with you at birth. Also to think about the scenarios in which you would have to give up on your birth plan, and what you would do in such cases. ( I think it is helpful to actually go ahead and both visualize your labor as it would be if it were perfect--and also to really think about worse case scenarios, and what you would do. That takes some of the fear away- to stare down those fears and take them out of the realm of the unthinkable. After I face those fears with each new baby, I spend many nights visualizing my birth from start to finish- through birthing the placenta and nursing the baby.)

 

[Naomi4Christ]

I think a birth plan is good if you are going against the culture of the place you are giving birth in. After all, the carers there cannot read your mind, and if you don't tell them what you want, they will do what they normally do instead.

You find out a lot as you go through your pregnancy, and once you have had the tour of the hospital. There's no point in putting down things that the hospital already encourages.

The other thing to keep in mind is that you might have to give in on one thing in order to get everything else that you want. In my US birth, I said that I did not want continuous fetal monitoring, but I had to give in an have a 20 minute session when I first arrived. They were then very open to the rest of my wishes.

It's good to keep the birth plan to just one side of A4/letter paper, and have just a few points for each part of labour.

If you want something that may sound like you are putting you or your baby at risk, it's a good idea to be armed with the research evidence - but to clear it with your OB or midwife in the last weeks of pregnancy.

 

[RoseofLima]

I think a birth plan is good if you are going against the culture of the place you are giving birth in. After all, the carers there cannot read your mind, and if you don't tell them what you want, they will do what they normally do instead.

You find out a lot as you go through your pregnancy, and once you have had the tour of the hospital. There's no point in putting down things that the hospital already encourages.

The other thing to keep in mind is that you might have to give in on one thing in order to get everything else that you want. In my US birth, I said that I did not want continuous fetal monitoring, but I had to give in an have a 20 minute session when I first arrived. They were then very open to the rest of my wishes.

It's good to keep the birth plan to just one side of A4/letter paper, and have just a few points for each part of labour.

If you want something that may sound like you are putting you or your baby at risk, it's a good idea to be armed with the research evidence - but to clear it with your OB or midwife in the last weeks of pregnancy.

I have found that with the EFM that you can just ask the nurses to see if they can first try getting fetal heart tones with you standing up, or on your hands and knees. Most hospitals require a 20 minute strip (who knows why)--but I have found that 99% of the time it doesn't need to be done lying on your back. You just have to ask!

The reason I think birth plans can be an impediment is because once again it makes others responsible for your care. I have found that just telling the nurses what I want to do in a non confrontational way is the best way to get what I want. I do think they can be helpful in cases where a woman doesn't have anyone to help her communicate her desires if she is unable to do so. I just think that most of the stuff on a birth plan ought to have been settled with the doctor ahead of time, and that just talking with the staff at the hospital is usually adequate to receive the care you desire.

 

[Leanna]

This hospital has wireless fetal monitoring.... I should be able to walk around with it, still awkward, and I might ask them to remove it for some of the time, but I might be able to work with it.

 

[Naomi4Christ]

This hospital has wireless fetal monitoring.... I should be able to walk around with it, still awkward, and I might ask them to remove it for some of the time, but I might be able to work with it.

Mobility is not the only issue with CFM.

 

[busybusymomma]

Hey! I know you! I recognized your avatar, you have it on another site...

BTW your wishes are not unreasonable but I had terrible luck with those things (I did have a birth plan) at my hospital birth, so part of the reason I chose homebirth for #2 and #3.

Have you talked to your doc/mw about it yet? Some hospitals/doctors are more progressive, others not so much... and though the doc/mw can override hospital policy, s/he is not there the whole time so it helps if the hospital has good policies.

So I'd like this delivery to be both comfortable for me, as well as helping our breastfeeding relationship, so I have a silly little "wish list" for this birth.

I was wondering if anyone has gotten their hospital to LISTEN to you on the following items:

I'd like to be able to nurse right away -- meaning before they weigh or measure the baby and even while the cord is still attached and I haven't birthed the placenta (only if the cord is long enough though, but the point is that I want to breastfeed sooner rather than later)

I've read that not clamping and cutting the cord until it stops pulsating, or at least not *right away* helps with preventing jaundice because the baby gets the last bit of the blood from it. So I would like to wait at least a bit, and not jump right to cutting the cord.

I don't want an IV, its distracting and I do not need it.

I want to be able to snack during labor.

 

[Leanna]

I think I am going to get a good feel for how things are at my appointment this week.

Yeah, I like that site.... very friendly, and nice and crunchy

Mobility is not the only issue with CFM.

What are the issues then?

 

[GolfingMom]

Here's my approach-- forget them! It's my body, my baby- and I am their customer. I PAY them...they will do what I want. Period. Nobody is going to rip food out of your hands or kick you out of the hospital while you're in labor...so just eat if you're hungry. Walk around if you want, refuse whatever you want.


)

I disagree with this. If you don't agree with their policies...don't use them. It almost sounds to me like LEANNA would do better with a homebirth/non hospital birth.
Hospitals have their policies for a reason - whether we agree or not with them, they are there for a reason...

 

[Leanna]

Hospitals have their policies for a reason - whether we agree or not with them, they are there for a reason...

The first two things on the list, the hospitals do them otherwise because they are in a hurry, and no other reason. They don't have time to let the cord stop pulsating. They are in a hurry. For the same reason hospitals and doctors are known to yank the placenta out of the woman rather than letting her body birth it, sometimes leading to serious bleeding problems. I have a problem with hospital policies that are all about money and politics, yes I do.

As far as IVs and food, they are the same issue, hospitals are used to medicated births and for those you need an IV. I am not having a medicated birth and so I will not use an IV, but sometimes they try to make you do it anyway because of this sociology concept called "formalism." Its what's always been done, therefore they do it-- formalism. There doesn't have to be a real reason.

If I wanted a homebirth, I would have said so.

 

[bliz]

Hospitals have their policies for a reason - whether we agree or not with them, they are there for a reason...

The reasons are usually to protect the hospital and its employees if there is a lawsuit.

 

[Leanna]

Well then explain it to me, I'm sure I didn't explain it that far off. Its like the woman who cuts the ends of her roast because her mom did, only to find out her mom did it because she had too small of a roasting pan to fit a roast. That's the word my sociology professor used and he told it to us like 1000 times, and explained it to us 1000 ways, it would be disappointing to learn he has it wrong since he was the department head.

Why it would be funny to laugh at someone getting something wrong, I can't imagine. And why you had to come and post on a thread and not even touch the topic, well I can't imagine that either.

The dictionary says formalism is:

1. Rigorous or excessive adherence to recognized forms, as in religion or art.
2. An instance of rigorous or excessive adherence to recognized forms.

That's what I am talking about ... people adhering to recognized forms when there really is no reason, except thats the form and thats the way its always been done. There doesn't have to be a reason. There are more details to the word meaning but it doesn't apply here. If you have anything further to say on the subject how about you just PM me rather than clogging up a thread in which you didn't even address the subject?

 

[RoseofLima]

This hospital has wireless fetal monitoring.... I should be able to walk around with it, still awkward, and I might ask them to remove it for some of the time, but I might be able to work with it.

Have you read the Henci Goer book..A THinking WOman's Guide to a Better Birth? You might really get a lot out of that book..it has a lot of statistical info.

Continous fetal monitoring= increased C-section rate, without providing better outcomes for mother or baby. Intermitent fetal monitoring with the handheld doppler has equal fetal and maternal outcomes with far lower c-section rate. There is no scientific reason to have continous fetal monitoring with a normal birth.

 

[RoseofLima]

I disagree with this. If you don't agree with their policies...don't use them. It almost sounds to me like LEANNA would do better with a homebirth/non hospital birth.
Hospitals have their policies for a reason - whether we agree or not with them, they are there for a reason...

A woman has a right to the birth she wants in the settin gwhere she feels most comfortable. Do you not think hospitals are there to make money and court customers? Think again. Hosptials are big business. If you are at a hospital- you are a paying customer. Name me one other business where the customer isn't always right- even to a fault (anyone who has worked retail, ever has stared that reality in the face). I am paying them to perform a service, they ought to be competing for my business by catering to my needs.

The reason hospitals have the policies they do in regards to birth is complicated...especially in America where with the technology available still lands the US way down the list of maternal and fetal morbidity and mortality rates. Which I find ironic- because most of the policies revolve around not getting sued.