How to know when to listen/ignore?

[Tigerlily01]

I am wondering how all you lovely ladies decide when to listen to the doctor and when to say "no thank you" to procedures, if giving birth in a non-natural-friendly environment (like a typical American hospital)?

 

[surprisedmama]

I would use the "time test" in this case. If they recommend something you aren't comfortable with or need to talk about, ask first if you or your baby is at immediate risk, if no, then say you want some time (10-15 or whatever) to think about it. Also ask them for the pros and cons for everything they recommend and ask if the procedure is to benefit you or to save time for the doctor.

If you or your baby is at risk, they won't be able to give you time and they'll tell you.

 

[EmmaRea]

This would be where a doula would really come in handy.

 

[LockandKey]

I agree, doula or midwife, as they will do their best to give you positive support to get the natural birth you want and will only suggest intervention unless utterly necessary, such as you or your baby's health being in jeopardy.

I had a doctor and nurses with my first birth, and it was awful, I was so confused, unsupported, no one was there for me to help me through the pain or explain to me why things were happening the way they were or what I could do about it. I ended up with intervention after intervention and narrowly escaped a C section. I promised myself to never allow that to happen again.

If they come in and try to push some medication on you, I would ask as many questions as possible, use your best judgement from that and decide if you are comfortable or if it's necessary to proceed with the suggestion.

Also, I suggest you go to the library and borrow some books on birth and labor and all the different methods used, why they are used, and how to avoid them if possible. You might still be new to all this, but education and understanding will always work in your favor

 

[aliss]

I agree with a doula.

Unfortunately "consent" is a dodgy issue in labour- I don't mean to scare first timers, but many women will find the pain so overwhelming that you want to die and can't think straight. That's an issue to be prepared for. I was begging for a C-section with my first, despite it being not what I wanted. I just wanted the pain to stop.

I *personally* "consented" to: increased pitocin, morphine, an epidural, an episiotomy, and my baby being squashed onto my boob with his broken collarbone being further damaged. That "consent" IMO, wasn't really consent.

I think if only I had a doula...

Anyways, the second time around I *DID* have a doula - but I also had midwives who were very clear on my expectations and VERY supportive of natural birthing (here in Canada, you pick your midwife and you keep the same one - she was like my best friend, really). My doula would have stood up for me if the midwives were to try and do unnecessary things against my goals but she didn't have to because I chose the right midwives in the first place.

Just IMO but I would really try and find midwives who support your idea of how birth should be. Failing that, a doula is (IMO) a necessary tool for a natural hospital birth.

 

[aliss]

One thing I should add, knowing my midwives were supporting my goals of natural birth, actually made the pain easily bearable. I didn't want to die, I didn't even want a tylenol. It put me in a totally different psychological frame - like I was getting through it on my own free will and I was in charge, rather than it being "done to me".

 

[Sam Pearson]

There is a lot to research, especially the first time you birth, and I was tor between reading about the problems and avoiding reading that kind of stuff.

If I was seeking a natural birth I'd definitely go for a homebirth.

 

[Tigerlily01]

Thanks, everyone!

 

[LockandKey]

Thanks, everyone! I have heard of doulas, but don't really know much about their expertise. Do they have enough medical knowledge to know when I should listen to the OB and when it is REALLY my choice? Or are they more there to be a support person and not likely to interject an opinion?

I am required to use the local military hospital unless I switch my insurance, so I won't have any choice of OB vs. midwife...they are all OBs, and you just get whoever is on call. I guess I'll have to see how supportive they seem and then decide whether or not to switch insurance companies...hmm...

I do like the idea of asking to wait 15 minutes after each procedure is offered though, and getting all the pros and cons. I'm just afraid I'll be too out of it and stressed to think everything through rationally!

Does your hospital not offer a midwife program then? I had DD in a military hospital as well, and they provided midwives, I had to make sure to ask for it first though

 

[Tigerlily01]

.

 

[aliss]

A doula is not a medical professional, she is a labor assistant, or, your advocate- so, for example, if the nurses start saying things like "oh if we give you an epidural, the pain will go away" and your goal is to NOT have an epidural, then she will speak up for you in the times you may feel too weak to speak up. My doula also provided pelvic pressure/massage relaxation which is something nurses will not do, and believe me, it makes a HUGE difference in pain relief! It is also very motivating to have a natural birth advocate with you at the time. Labour is just as mental as it is physical.

The nurses really don't care how your labour goes aside from just getting the baby out. The doula is there to speak up for you and help you achieve your desired birth, particularly in an environment that does not support it.

 

[jensha]

^ Just a little correction. Doulas are not allowed to talk to the medical staff directly, but they will talk to you and remind you what you had on your birth plan. For example, they won't tell the nurse " she didn't want an epidural", but will ask you "hey, remember, you really didn't want an epidural. You know you can do this without it, you were pretty sure of it when we talked before labor".

I think it's really helpful because when you're in pain and exausted, you're vulnerable and after a certain point, you just don't care and say yes to anything that could make your life easier. However, once it's done, you regret it.

 

[aliss]

Oh must be different here, doulas are allowed to speak with medical staff, mine was chatting with them all night!

 

[fionar]

^ Just a little correction. Doulas are not allowed to talk to the medical staff directly, but they will talk to you and remind you what you had on your birth plan. For example, they won't tell the nurse " she didn't want an epidural", but will ask you "hey, remember, you really didn't want an epidural. You know you can do this without it, you were pretty sure of it when we talked before labor".

I think it's really helpful because when you're in pain and exausted, you're vulnerable and after a certain point, you just don't care and say yes to anything that could make your life easier. However, once it's done, you regret it.

Oh must be different here, doulas are allowed to speak with medical staff, mine was chatting with them all night!

This. My mom's a doula and interacts with the medical staff all the time when she's at a birth. She's there to advocate for mom, so not being able to talk to the medical staff would seriously hinder that. Perhaps it depends on where you are?

 

[jensha]

^ I guess your right. It must depends where you are. That's how my doula told me things were gonna go and I also watched a video from my midwife in which there was a doula and she just talked to the mom, but not directly to the staff. Maybe it's just in my state

 

[fionar]

^ I guess your right. It must depends where you are. That's how my doula told me things were gonna go and I also watched a video from my midwife in which there was a doula and she just talked to the mom, but not directly to the staff. Maybe it's just in my state

If it was just in a video, it could also depend on what mom said she needed/wanted from the doula. My mom's had clients who've asked her to keep staff away from them in terms of offering drugs because they've decided they'll ask for them when/if they're wanted, so my mom does that. Other moms just want her there to give them ice chips while their husband goes for a walk and takes a breather. To each his/her own, right?

 

[solitaire89]

I am wondering how all you lovely ladies decide when to listen to the doctor and when to say "no thank you" to procedures, if giving birth in a non-natural-friendly environment (like a typical American hospital)?

I would like a natural birth, but if something happens that I haven't specifically researched, how do I know when they are shoving hospital policy down my throat and when they are recommending something that is necessary for safety (of myself or baby)? I guess I'm just afraid that as a first timer, I would be pressured into doing things I don't want to do because I am ignorant...but not having a medical degree, how do I really know when something really is for safety and when it is for the hospital's convenience? I have lower back problems and want to avoid an epidural at all costs (so therefore want to avoid anything that might lead to epidural), but of course if there really is a need for an intervention I don't want to turn it down if there is risk to myself or baby...

????

The medics will very often use all of the tricks under the sun to get you to agree to things, the most common being the "it's best for your baby" card without any justification. The first question that you/your Birth Partner need to be asking is "Are either Mum or baby in immediate danger?" If not, then ask for 30 mins to make a decision.

If they pressure you to make a decision then use your BRAINS:

B - How will this be beneficial?
R - What are the risks?
A - What are the alternatives?
I - What do your instincts say?
N - What if we do nothing?
S - Smile!

Get this printed off and laminated so that your BP has it to hand. I would also second the plan of a doula, especially as you will be in such a "non-natural-friendly environment" (I love that description!)

Hope this is of some help!

 

[Kess]

My MW taught me BRAD:
What are the Benefits, Risks, Alternatives, and what happens if we Do nothing?

Very useful for all medical stuff, but especially pregnancy and birth, when women are often treated very much like silly little children who don't understand or have a right to make choices IMO.

 

[madasa]

As a doula, I will not directly contradict the staff and I can't look as if I am "directing the birth". I will give the mother and father every chance to speak for themselves! If a midwife is coming in snapping on her gloves and saying "I am going to examine you now", I talk to the mum and say, "The midwife would like to examine you. Is that alright with you?" This isn't because I am not allowed to talk to the staff, it's because the mothers voice carries more weight than mine. My job is to make sure it's heard! Also, I don't want to be "in charge" and saying how things are supposed to go, I want the mother to have that power. If it looks like it's shifting towards the staff because she is vulnerable and maybe not very lucid, then I try to give it back to her. HTH