I am about to say something that strikes fear into the heart of every crunchy mommy…
“I had a hospital birth.”
Now before you grab my hand in sympathy and ask if I want to work through my birth trauma, you need to know there’s more. It was awesome. I was respected, informed, and empowered. It was everything I could hope for, and I felt that I compromised nothing. Hospital births don’t have to be seen as waving a white flag to your own powerful path to birth, but they do require a bit more planning than other environments. The following is not meant to be construed as medical advice but rather practical suggestions based on my own experience.
First of all, say this loud and proud: “My doctor works for me!” Your OB is being paid to provide a service to you, not the other way around. Whether you are limited by Medicaid, insurance, high risk, or military, you still have several OB options even in a small market like Southeast Texas. You need to do a consult with as many as you can and treat it like a job interview for them, because IT IS. Ask about their induction, c-section, and epidural rates. Talk about what you hope for in your pregnancy and birth plans. Do not let them try to blow it off for later, because they know the answers now. My pregnancy cost us $13,000 out of pocket which is the same as a brand new Nissan Versa. You’d better believe I asked as many questions as I would if I were buying the car instead.
Pick the doctor is who is the best match for you. Then educate yourself as much as possible. You cannot be prepared for every contingency, but being able quote ACOG information and studies when making medical decisions will help you feel confident and your doctor understand your position.
Research common issues including induction protocols, pain management, and normal labor progression. Consider hiring a birth professional (doula) to support you during labor and help with coping. Labor can be a stressful time and so a person who is there to help you, but not personally invested can be invaluable. I want you to memorize 3 little letters that will help you in many battles during pregnancy and delivery, “AMA” or against medical advice. If your doctor says he would like to do or not do something, ask if he’d be willing to write an AMA on it. Often times, your OB’s suggestions are preferences rather than medical necessities. During my labor I ate, drank, walked the halls, refused IV, declined fluids, didn’t have continuous monitoring, and never laid flat on my back despite these being the “normal protocols.” None of these were deal breakers for the OB and when we stumbled across one that finally was, he was honest that doing so would be against medical advice. I was happy to engage in informed consent at that point.
A final piece of advice is to use your nurse as your advocate and your doctor as your judge of importance. What I mean by this is that 99% of your interactions will be with your nurse. During my 17.5 hour labor, my nurse never suggested pain medication or epidural because I asked her not to. She reported to the OB that I was in good spirits and everything was good. If you know hospitals they like a centimeter of progress per hour and since I started at a 4, one of her primary roles was as my very valuable ally in minimizing intervention. If the nurse comes in with “doctor’s orders” such as Pitocin, pain meds, or such, ask politely to talk to your OB. If it’s an emergency, let your OB be the one to tell you. If not, you have the right to make an informed decision. While a healthy baby and mother are obviously the primary goals for any labor, they don’t necessarily contradict an empowering delivery. The birth experience has long range physical and emotionally impacts for the birthing dyad, and the only way to improve this in a hospital setting is to demand respectful quality care.
Lacking a hobby, Renae Rose has spent the last four years pregnant or nursing her daughter Emelyn and son Macallan. She is a full-time teacher at an online charter school. In her spare time, Renae enjoys laughing at her kids’ hijinks and alienating people on Facebook.