Lots of questions and need support (long)

[grey_pony]

I am in the US and will be delivering in a hospital. The midwives and OBs rotate, so you never know who you will get for the delivery. I was feeling very conflicted about an epidural and induction until I watched The Business of Being Born and started reading more. Previously, I was terrified of an epidural on the off chance that I would be paralyzed, or have severe back pain, or a spinal headache - and I don't want to be stuck in bed unable to move my legs during labor, with a catheter. I would feel helpless. Now, I am really not wanting it - I want my baby to come out safely on her own schedule, I don't want to put myself in a position of needing more and more interventions, and am absolutely horrified at the thought of having a c-section while awake!! I want the experience of giving birth, I want to trust that my body knows what to do, I want that high of hormones and emotions after delivery. I am also willing to accept that maybe I can't handle the pain, and would want an epidural at some point. I'm also willing to be induced or have c-section if it is necessary.

I try to express my feelings to DH, but it comes out in a jumble and he thinks I am reading "propaganda" and just scaring myself. I think he would put blind faith in doctors, and although he says he supports whatever I choose, I think if I were in pain, or the doctor said the magic words about putting the baby in danger, he and/or doctor could pressure me into things I don't want.

Also, I tried to discuss why I want to be able to be active during labor with DH, and got on the subject of how lithotomy is not the best position for labor. And how (for me) it feels really humiliating being on your back with your legs up and a stranger poking or looking around in there. He made some smart alec comment about how he is sure it is just a way that doctors like to humiliate women. But I really do feel strongly about it - I would prefer not to labor that way unless I find it comfortable. DH also doesn't want to hear about anything graphic - like tearing, or anything really gross. I got upset when he said to leave out the graphic details - I HAVE to go through this, in all it's graphicness, and he is going to be there to support me. I know he can't possibly understand all my emotions or fears. I just hate when he dismisses them as if I am being silly. He said I should stop reading about labor and birth on the internet since I just scare myself. He won't watch Business of Being Born, he doesn't want to read my "propaganda" (anything promoting distrust of medical professionals), and I think he would only accept my concerns if an actual doctor were to back me up. I feel like I have to be my own advocate and emotionally support myself through the birth, since I feel like DH would willingly volunteer me to be cut open if the doctor said so. I just want HIM to be pregnant and feel how real my fear is. I haven't even tried to discuss with him how I am convinced that just the "pressure" of being in a hospital, with staff constantly in and out of your room, the unfamiliar environment, and being on some kind of "schedule" could hinder the labor process. He would think I was being all hippie and dramatic if I mentioned it. But I do believe that our bodies are very sensitive to such things. I tried to liken it to a horse who goes and finds a quiet place to birth, and will often even not have a foal if humans are watching. I told DH I could probably go give birth in a field and my body would know just what to do... he said, well then why bother worrying, reading and scaring yourself if it knows what to do. He just does NOT UNDERSTAND.

A few questions:
1. How do doctors determine the baby is in danger - is it just from monitoring heart rate? Position in the womb?

2. Can you refuse an epidural, induction, or c-section in all instances? When can you NOT refuse them (I would of course agree to any procedure necessary for the health of my baby)?

3. If you labor at home for as long as possible, how do you know for sure when to go to the hospital? We live about 45 minutes away.

4. I am confused about when the water breaks - can't you be having contractions for a while before the water breaks?

5. When should I refuse to have my water broken by the doctor, and when is it necessary? Can you refuse to have your water broken?

6. If I want to be active during labor, should I request not to have an IV started (very routine here)? Is the only purpose of the IV so they can administer pitocin or pain meds at a later point? Do you need the IV to stay hydrated? How can they NOT allow you to drink water - I think that is stupid??

7. If you do not have an epidural, and want to walk around, can the hospital staff really MAKE you stay in bed?

8. Do you have to deliver in the lithotomy position if the doctor tells you to?

9. How can I talk to my OB about having a natural birth without sounding bossy or demanding?

10. Can you refuse an episiotomy? When is it smart to request it, or allow it to be done?

11. How long can you be in labor at the hospital before they get pushy about pitocin or a c-section? When is it important to say yes to interventions, and when should you stand your ground and say no?

I would be inclined have a homebirth if it was possible, but I have to give birth in a (very nice, and so far very professional) military hospital. I want to make a list of questions and a birth plan to discuss with my doctor at my next appointment at 33 weeks. I will also find out if I can tour the L&D floor. I am just so scared that I will not be in charge of my own body, and nurses and doctors will try to make decisions for me, and I won't be strong enough to stand up for myself.

Or maybe I will be pleasantly surprised by the hospital and doctors. I have heard the nurses can be pushy at this hospital, so I want to be prepared to know when I can say no, and when I should say yes to things. if you read all that, THANK YOU!

 

[Samantha675]

Let me start by saying you are asking some amazing questions and I applaud you. So many women don't.

While I can't answer many of your questions, I think you have to do the research on them, and answer them for yourself. Yes, take them to your doctor, and compare your OBs answers to the ones you find yourself, and then you can argue for a position of knowledge.

A lot of what is done in American hospitals has nothing to do with patients, it is hospital protocol, and insurance policy. It sucks, big time.

I will do my best to answer your questions, so of this is just my opinion, so I hope not to offend you or upset you or such:

A few questions:
1. How do doctors determine the baby is in danger - is it just from monitoring heart rate? Position in the womb?

I believe it is down to fetal monitoring, and the baby's heart rate, and when it drops. There is a certain time during or just after contractions that a baby's heart rate will drop, and it is normal, but if it doesn't recover quickly enough, or drops at the wrong time, or speeds up, then that is a distress sign. But it is not 100%, you can request to be monitored every so often, and not continually.

2. Can you refuse an epidural, induction, or c-section in all instances? When can you NOT refuse them (I would of course agree to any procedure necessary for the health of my baby)?
You can refuse anything that you don't feel comfortable with. If they want to induce you before your due date, ask why? Is it policy? Inducing just because that is how it done is not a good enough reason for me. If you have a valid medical reason for an early induction, then that is a different story. But saying 'oh the baby is getting too big, isn't good enough."

3. If you labor at home for as long as possible, how do you know for sure when to go to the hospital? We live about 45 minutes away.
You don't, you have to listen to your body and time it. Every labor is different, and you could wait until your contractions are 3 minutes apart, and head off and get there an things slow down. Or like my doula, she doesn't dilate at all till the last hour of her labors, then boom she goes from 1-10.

4. I am confused about when the water breaks - can't you be having contractions for a while before the water breaks?
It breaks when it breaks. My water broke before I went into labor. Some don't break till they are pushing.

5. When should I refuse to have my water broken by the doctor, and when is it necessary? Can you refuse to have your water broken?
Of course you can refuse. I don't know when you should, or if it is necessary. I know it can make your labor speed up, but it can also cause problems. If you are having a longer labor, many hospitals don't like you to go over 24 hours once your water is broken. A friend of mine's broke 3 days before her baby was born, and if she had been at a hospital they would have sectioned her.

6. If I want to be active during labor, should I request not to have an IV started (very routine here)? Is the only purpose of the IV so they can administer pitocin or pain meds at a later point? Do you need the IV to stay hydrated? How can they NOT allow you to drink water - I think that is stupid??
It is a policy thing, it makes them easier to administer drugs when they want/need to. You can request that the needle be inserted, but not attached to the IV. Not eating/drinking is another policy as well. Some hospitals will allow water or ice, but no food, but you can always sneak it. There is a fear if you have to have a c-section of vomiting.

7. If you do not have an epidural, and want to walk around, can the hospital staff really MAKE you stay in bed?
NO one can make you do anything. BUT you have to be willing to fight them if you are going against policy. This is very hard to do when you are in labor. You are in a very vunerable position. And once you are laboring, it can be hard to fight for what you want. This is why having an advocate by your side is so important. Be it your husband or a doula. They can help be the buffer between the staff and you, and help make sure you get what you want.

8. Do you have to deliver in the lithotomy position if the doctor tells you to?
This position is policy, and it is the best position for the DOCTOR, certainly not you! Again, it is a fight, but you have to listen to your body.

9. How can I talk to my OB about having a natural birth without sounding bossy or demanding?
Why should you not be bossy or demanding? This is YOUR birth, it will be yours for the rest of your life and will affect you. This is just one birth of many for your doctor. If you do your research, and know what you are talking about, and why you want things the way you do, you are just being an informed consumer. Remember that is what you are, this is a service YOU are paying for. Most of us research the car we buy, the TV and loads of other stuff, why shouldn't you research what you want for your birth. This is hugely important, way more than which car you buy. If your doctor is unwilling to discuss these things with you, or very dismissive, try to get a different doctor!
10. Can you refuse an episiotomy? When is it smart to request it, or allow it to be done?
Yes, you can. The problem, is much of the time a cut is going to be deeper and longer than a natural tear would be. With the right peranial support, your chances of tearing are decreased, but most doctor cut you because it is policy.

11. How long can you be in labor at the hospital before they get pushy about pitocin or a c-section? When is it important to say yes to interventions, and when should you stand your ground and say no?
It depends on the hospital really, and what your doctor is like. You have to decide which interventions you are ok with, and when. Research and research. The more you read the more you will know. Make a birth plan, and make on that looks at all the eventualities, interventions, c-section and such. Give yourself that power and control.

Your husband is a tough one. If he is unwilling to educate himself on the issues that are not only important to you, but are going to effect you and your baby, then maybe he shouldn't be with you during labor. You need support, that is very important. It might be better for you both if he was not there. Some men just don't and won't get it. This is your birth, your experience that you have to go through. Men won't give birth and I don't think some of them understand how deeply personal and life changing it is for a woman.

All I can say, is have a very honest talk to him about this. How important these things are to you. Birth can be life changing for a man as well if he is open to seeing it from your point of view. I know that my son's birth was far from satisfying for my husband.

Think about getting a doula, especially if your DH won't get on board. If cost is an issue, speak to some local doulas and see if they have an apprentice doula who could attend your birth for less money. There is a group here in Austin, that an on-call apprentice doula starts at just over $200. Or if they have a payment plan, or discount military service families, or will take a reduced fee, or trade.

Other films to watch:

Pregnant in America, your DH might watch this as it is from a man's prospective.

Orgasmic Birth, it was good,and I am totally jealous of this one woman's birth. If you watch it you will know the one. She is in a hot tub, and in NO pain.

I hope this helps. I think a lot of your questions are ones you have to find the answers to.

 

[fides]

I am sorry you are having a difficult time getting DH on board with understanding your fears/concerns. Have you thought of hiring a doula? When we were planning to go the hospital route, I was going to hire a doula as labor support. We were going to labor at home with her, then she said she'd be able to tell when it was time for us to head to the hospital to try for a natural birth. I think your odds of having the natural birth you want will increase if you have a supportive person there, and I do hope that your DH changes his mind on some of his attitudes.

As for interventions, i know you can have a birth plan, and the OB or midwife can even agree to things beforehand, but in the heat of the moment, depending on the hospital and doctor, those requests are not always honored or remembered. My doula said part of her job with hospital births has been to watch what is going on and to tell the laboring woman things like, "The doctor is about to cut you - if you don't want that, you have to speak up now and tell them you refuse your consent."

Also, a lot of your questions have to do with individual hospital policies, so in addition to asking such questions to your OB, I would call and ask the hospital about their rates for the different interventions you are concerned about, how many women are allowed to move, deliver in any position, alternatives to IV's, etc. Every hospital has its own policies/protocols, so what you are able to do will vary.

I will say I do have a friend who has given birth twice in a military hospital, and she had wonderful experiences there with natural, unmedicated births. Her experience sounded like it would have been better than what my local civilian hospital offers, which again tells me that so many things just depend on the particular hospital.

I do hope that you get some positive support soon, and that your OB is able to act according to your desires!!

 

[Mervs Mum]

All I am going to add is this.....(and honestly I dont say this often and people here know me and will confirm this)....hire a doula. Xx

 

[qwk]

ditto all above, consult a doula. that way you have a person who will be very open to ALL the things you are talking about, and who will understand more than your husband - and will very likely be better at explaining it to your DH than you are AND she will be able to be the intermediate between you and the doctors/midwives/nurses; that way, instead of having to explain for the 10th time that you don't wan an epidural, the doula can do it

 

[grey_pony]

Thank you all! I have contacted a doula. DH and I also had a discussion last night, and it went well. He really listened to me without interrupting. He is on board with the birth plan I have so far, and was asking questions, and I think he will be able to advocate for me if necessary. We did talk about home birth and it freaks him out, and he considers it irresponsible when hospitals are available, but I can live with that!

 

[Mervs Mum]

Sounds like a very positive position to start in. Lots of partners feel just like yours. Even mind took some convincing and now he's the biggest home birth advocate out there.
A doula is there to support you both so I'm sure he too will find her helpful x

 

[lynnikins]

1. How do doctors determine the baby is in danger - is it just from monitoring heart rate? Position in the womb?
typically this is done by montoring the heartrate which doesnt have to be a constant process its quite enough for them to monitor it every 10-15 min instead of constantly being strapped to a machine

2. Can you refuse an epidural, induction, or c-section in all instances? When can you NOT refuse them (I would of course agree to any procedure necessary for the health of my baby)?
Yes you can its your body and your baby if they forced anything on you can sue them of course it is wise to take some advice from sombody on how your labor is going so a doula might be helpful
3. If you labor at home for as long as possible, how do you know for sure when to go to the hospital? We live about 45 minutes away. for me with ds1 contractions were a min long and 5 min apart when i gave in and went to hospital ( was induced second time so already there )

4. I am confused about when the water breaks - can't you be having contractions for a while before the water breaks? i labored for 52 hours with ds1 before my waters broke and they broke with ds2 about 20 min before he was born just as he started coming down the birth canal

5. When should I refuse to have my water broken by the doctor, and when is it necessary? Can you refuse to have your water broken?
in my mind always lol i personally feel that the waters being intact can help keep baby calmer during labor and makes labor more comfortable, some babies are born with their waters intact, obviously though if there is meconium spotted in the waters ( how they would i dont know without them breaking ) then something might need to be done

6. If I want to be active during labor, should I request not to have an IV started (very routine here)? Is the only purpose of the IV so they can administer pitocin or pain meds at a later point? Do you need the IV to stay hydrated? How can they NOT allow you to drink water - I think that is stupid??the IV is purely a " just in case" measure you should at least be allowed ice chips to suck on in labor and theres studies that show its better to allow the woman to drink than to hydrate her via IV

7. If you do not have an epidural, and want to walk around, can the hospital staff really MAKE you stay in bed? good luck to them if they try lol, i would think it would dpend on the hospital but if they want you to have the easiest birth possible they should go with your wishes to be active in labor ( check with them if you can take a birthing ball or if they have them )

8. Do you have to deliver in the lithotomy position if the doctor tells you to? I would say no as this position unless required by something ( even with an epidural they can use the left lateral position so i dont know what would require it ) then you are entitled to birth in whichever position you choose, talk to your OB but any OB worth their salt should be able to do a forceps or ventouse delivery with the mother on her side

9. How can I talk to my OB about having a natural birth without sounding bossy or demanding? i would talk to them about your fears and how you want to be in control of your birth as you are the one inside your body and know what you feel and have ideas on how you want it to go ( also having a doula will help )

10. Can you refuse an episiotomy? When is it smart to request it, or allow it to be done?yes you can refuse one absolutely they can do forceps and ventouse births without them if needed although personally i didnt find it that bad and it did help with the ventouse for ds1

11. How long can you be in labor at the hospital before they get pushy about pitocin or a c-section? When is it important to say yes to interventions, and when should you stand your ground and say no? thats down to your hospital but labor in itself can take several days so make sure you are aware of all the facts and ready to say no i want more time if you want it. You should only say yes to something when you have had both pros and cons explained and YOU (not the doctors) decide that with that knowledge its the best option for you and your baby

 

[Samantha675]

Sounds like a very positive position to start in. Lots of partners feel just like yours. Even mind took some convincing and now he's the biggest home birth advocate out there.
A doula is there to support you both so I'm sure he too will find her helpful x

I think once men start to educate themselves on home birth/natural birth, they really get behind it. They realize how much better it is for the mother and the baby, and what it can mean for them as well. They become a much much bigger part of the birth.

 

[Saljae]

My husband sounds just like yours and all the questions you asked here I have as well!!!
I figured out today that we just really cannot afford a home birth and was so sad because I hated my hospital experiences, especially the last time.

Now the plan of action is to find a doula and really try to figure out how to do what I want while in the hospital.

Does anyone know if you can leave the hospital *before* the 2 days is up? I hate being away from my children and husband for so long. :/

 

[Samantha675]

Saljae, I don't see why not if you have a straight forward vaginal birth and baby is doing fine. You may have to push for it. I was out in 2 days after my c-section because I wasn't resting, and we both were fine. My husband went to my doctor and asked what the hell we had to do to get out of there, and asked the pediatrician as well. Both promptly released us.

 

[jcg0506]

You've gotten a lot of great advice, and I'm glad you've contacted a doula and that your husband is getting on board. Esp. in the hospital setting, you really need an advocate in order to have the birth you want. Obviously, some hospitals and doctors/nurses are better than others about respecting your wishes and not trying to pressure you into what you don't want. I would have a long conversation about all these things with your doctor; if you feel like he/she is not really on board with how you want to birth, I would try to find someone who is. I don't know what options you have at the military hospital, but definitely do research on the doctors and the policies so that you can get someone who is in tune with your preferences, or in the worst-case scenario, you will be prepared to fight for what you want. Good luck!