Friday, May 11, 2012

Calling on my Girls!

As Eli's birth begins to loom, I'm thinking over my last two birth experiences. Because I planned to have both Claire and Jude at home, and ended up in the hospital BOTH TIMES (for two different reasons) I've decided to start off at the hospital this time. But, I am discovering I have no idea how to plan for that. It's like the first time all over again, not knowing what to expect. All my preparation for birthing has always been predicated on being at home. The hospital is a foreign place to me, and only ever experienced during the dire moments of emergency. They have always involved feeling railroaded, mistreated, yelled at, and scared. So, now the thought of voluntarily going there and spending much more of my labor, delivery, and postpartum recovery there is frightening to me.

I need advice and encouragement from the wonderful moms and dads in my life who have had POSITIVE hospital birth experiences- especially if you have done an unmedicated birth. Tell me what I should be prepared for. I need simple tips, like what to pack in my bag, (I've never packed a hospital bag before!) How were you able to focus and stay comfortable? How easy was it to do your own thing and avoid being meddled with by the nurses (even the well-meaning ones)? When did you go into the hospital? I'm thinking of staying at home until I'm all but pushing, but then the thought of trying to get there when things are the most intense kind of stresses me out! Will I feel rushed? Will it make it impossible to relax through the most powerful contractions? But if I go too early, will I be more vulnerable to routine hospital procedure that may lead to intervention? I know I have heard many of your birth stories before, but it was with ears that were never expecting to need to remember the tips and details!

I know you will all have different experiences, and different advice. I want to hear it all! But seriously, please no horror stories, or anecdotes about how things turned out all wrong. I already have two of those myself to give me anxiety. I don't need to have them reinforced by your experiences too! Thanks guys!!


  1. Two unmedicated hospital births here... it depends on how you labor, I think. I am a fast laborer so it's all work from the time I get to the hospital to when the beeb arrives so literally, I'd say you need nothing other than a camera.

    Personally, I sort of internalize a lot when in the midst of the pushing, etc., so I didn't feel rushed and pretty much ignored the environment entirely. I'd say that having Kevin or your doula/MW handle the hospital nurses will save you a lot of pressure -- Brandon was extremely clear with them about my wishes for NO OFFERING of meds, and they were thoughtful and respectful. I appreciated being able to concentrate on what I was doing while someone else advocated my needs for me.

    If you want to read my birth stories, lemme know.

    1. Thanks Alison! I was especially hoping to hear from you because I knew you'd had two good ones!

    2. I do remember the one thing that made me really angry was the constant monitoring. The monitoring belt makes contractions more painful, IME, because of the additional pressure on your uterus, and I was getting pissed off at the nurses for making me wear it when they weren't watching the results. So, even though they kept telling me to leave it alone, when they were gone, I'd push it off. If they had a real reason for needing to see the output they a) could have stayed in the room watching it or b) told me the beeb was in distress. Instead, they were only doing it because it was SOP, and I had no need or desire for that at all.

  2. We had Jack at Littleton Adventist which was overall a really great experience. I was actually surprised at how "hands off" the nurses were - of course if needed something they were there immediately - but I guess I envisioned laboring in a room with Andrew and having some nurse staring at me or something... who knows.

    The monitoring was also kind of a pain for me - unfortunately because I have a heart condition my cardiologist also wanted me monitored and I felt pretty connected to machines. However, my new ob/gyn for this pregnancy said there are cordless options at that hospital (I guess the nurses don't want to deal with it so they just hooked me up to all the wires) that he'll make sure I have this round so I don't feel so restricted to my bed area.

    I think especially with your background with home births, you'll be more confident than I was in some of the things you want. Jack's heart rate was dropping during the end of labor during contractions so they had a vacuum to his head and I got an episiotomy - not a big deal to me as they were about to give me an emergency c-section which I definitely didn't want - especially when his heart rate didn't return up after contractions and they had me pushing even when I wasn't contracting. My doctor really listened to me about not wanting to use forceps (once the vacuum slips like 3 times they are supposed to and he had lots of hair so that happened and one of the nurses kind of pushed her and she ignored her and used it once more).

    The thing that upset me was that right when he was born, they didn't (or couldn't?) put him on my chest right away skin-to-skin as I'd requested. He was put into a warmer and checked immediately and they started to bottle feed him formula which was also upsetting. But I guess at the time it was all a blur and when someone says there's something wrong with your baby and we need to fix it, I didn't really ask questions. Then I got him on my chest and had plenty of time to bond before we were cleaned up and moved to recovery.

    The other thing that was upsetting (and again, I feel like you'd be braver and I will this next round) was that he was struggling to keep up his body temperature and blood sugars - so the first night they took him into the nursery to be under the warmer. I spoke with a friend later about it who asked if they tried just putting him skin to skin with me covered in blankets, but they hadn't. Again, I wished I'd asked. I think any part of the hospital experience that was the least bit "negative" for me was maybe due to me not challenging Jack and my caregivers enough.

    I didn't have the experience of a home birth before so I'm not sure if I can identify what was "different" about a hospital. Overall it was a really good experience - everyone was wonderful - esp. the nurses, my doctor was on my side and knew what I wanted from the birth but also knew that I respected her wishes as the medical professional to make decisions as needed, the food wasn't too bad and there was a fridge stocked with drinks and snacks, I was able to labor in a tub for part of it, I had a lactation consultant work with me the morning after he was born (would have loved her earlier to help me navigate the pump they had me use, too). It'll be up to you and your doctor at what point of your labor you actually go in - we were there right from the beginning - this round I might try laboring a bit more at home first.

    I guess we all know that you can make a birth plan all you want, but you never know how it's going to end up so you can just do your best to prepare and then just go with it :) I have a list somewhere too that I'll find and send your way.

    1. Thanks Laura. Those are some great things to keep in mind! I heard Littleton Adventist is a great hospital. My old midwife that left the practice was suggesting I go up there to deliver with a great midwife practice. She said it was the best hospital in the area. I decided I didn't want to drive 45 mins in labor!

  3. Here's my two cents:
    I would try to see if you can tour the hospital to get the lay of the land, so to speak. We got to tour the hospital and knew where to go if our baby came during the day or in the middle of the night.
    The doctor told us to head to the hospital when my contractions were 2-3 minutes apart. I would not want to wait until it is almost time to push since that might cause a lot of anxiety! It was time to push when I got to the hospital but I progressed very quickly. No medication for me but I also didn't have time even if I wanted any!
    I packed a change of clothes for me, the baby's homecoming outfit, a nursing bra, a camera, and a couple of granola bars (I need to watch my blood sugar).

    1. This comment has been removed by the author.

    2. I am having issues with with my name displaying on my post. This is your cousin Gina.

    3. Yes, I think I agree with you about the anxiety. I'd rather go a bit earlier, so I have an hour or so to get settled in before the fun starts (hah!). And I feel a bit prepared, having done this twice. I know the feelings and how they translate into what stage of labor I'm in. Thanks for helping talk me down from my breakdown!

  4. Allison and Laura have excellent suggestions, Rechelle. Especially the part about "you can make a birth plan all you want, but you never know how its going to end up." Obviously you know that and I think that might be why it is so scary for you.

    Just remember that you have already had the worst possible experiences and it can only be better this time. Your midwife will be your friend and ally during your delivery. Share your fears and ask her all of your questions in the next couple of visits -- write them down so you don't forget. She can tell you when she wants you to go to the hospital and what kind of intervention is non-negotiable. Most things that happen in the hospital will be at her direction and she will tell you if there is something the hospital absolutely requires. Even if she has standing orders for certain procedures, she can adjust them if she feels it will be safe for you and Eli. It might be a good idea to review the doctor's orders with your main nurse, just so there is no misunderstanding -- and review them again if there is a change of shifts. That especially applies to his care after he is born. If you haven't already, be sure to get a tour of the hospital so you can see the labor and deliver rooms and know where to go when the time comes.

    As far as what to pack -- the only thing I can remember is lollipops. :-) Maybe a small rubber ball to use for back massages. However, you might want to have something to keep your mind occupied between contractions and of course, something to wear home. Also, don't forget something for Eli to wear, and take it with you when you go -- don't leave it for Kevin to remember later!

    Finally, remember Kevin and probably your mom will also be there to advocate for you. You will do fine and when you see that sweet little face you will wonder why you were so concerned!

    1. I never thought to review the birth plan with every shift change. Good idea! I have to preregister at the hospital and they go over your birth plan then and I think enter it into your chart, so that makes me feel more confident that it will be seen. (That appt is in a few weeks.) I am not super familiar with the new midwife yet, and she doesn't seem to be on the same page as me, philosophy-wise on a few things. Luckily I still have some time to work those things out, but I think that's what caused my mini freak out. I'm better now though!

  5. After my first daughter (unmedicated hospital birth) there was very little I would have done differently except ask more questions during the hospital tour. It's one thing to go and look around before hand, but the person giving you the tour (usually a nurse of volunteer) has probably been doing it for a while and should be a wellspring of information. I didn't know, for instance, that my hospital actually provides yoga balls to sit on if Mom wants one. I found that out at the second birth, and man did my hips thank my nurse for that! I'd even go so far as to ask the tour guide what questions other moms normally ask and what information isn't always included in the tour but seems to be helpful. As far as advocates, your midwife and Kevin will be there and should know what your views are on the important stuff.
    For your packing list, the other ladies have done a great job on the basics. If you have a specific tool that has helped you in the past (like a yoga ball) ask if you can bring it! The answer is always no if you don't ask the question. My mp3 player and speakers helped me to focus when the contractions got really strong.
    Also, your insurance will be billed for a certain number of supplies whether you use them or not. If the hospital has something you like and think you'll use (lotions, pads, medicated wipes, etc.), take it! Consider it swag. I took home a whole extra days worth of "lady supplies" because they let me out early (and the amount they allot for a day lasts about a week!).

  6. Well, I've told you before, but I definitely had a positive, unmedicated, hospital birth experience! I stayed home until I was pretty much in transition (I think this is a better time to go than when you are ready to push...). So by the time we got to the hospital, I was 9cm and "in the zone", so the nurses were very efficient about the check-in process. They were actually very hands-off. As soon as we got in the room, my mid-wife (or mom, can't remember who) asked to dim the lights and they did. So all the check-in questions and vitals and IV were done with dim lights while I continued to labor with Davy and my mom. I vaguely remember answering the intake questions, but I was still able to stay focused on my labor. After that they left the room and didn't come back for 2 hours when they saw me pushing on the monitor (BTW, it may seem like they don't watch the monitors if they aren't in the room, but they have monitors at the nursing station displaying everything, so are usually checking it from there.)

    I actually did have a written birth plan that we gave to the nurses when we arrived, and I wasn't sure if they looked at it, until later when I looked back at things and realized they had done what I had written in there (like getting the mirror ready, keeping lights low, letting me move around, etc). So I think it's a good idea to have one even though, of course, things may not go as planned. I also had a great OB who didn't rush me in labor or pushing. Maybe it was just because she had a knee injury at the time, but she just sat there patiently while I pushed for 55 minutes. She also did not do an episiotomy since that was my request (even though the nurse was asking if she was going to do one).

    I don't remember being too bothered by the belly monitors actually. Mine had long cords so I was still able to be out of bed. But if you spend more of your labor in the hospital, you can ask about the cordless ones, or about intermittent monitoring. (If you want my medical opinion, there is actually NO good research data showing that continuous monitoring has any benefit to baby, so you can easily argue this point with your doctor/midwife). I actually did most of my hospital labor on the doctors stool, which I highly recommend!

    The one part of the birth I would have liked to have done differently was my position for pushing. My hospital didn't have a squat bar, but a lot of them do nowadays. So I was in the standard dorsal lithotomy (i.e. reclining spread-eagle) position, which worked fine, but I would have preferred a squat. So you can check in to those options if you want that.

    Things to pack:
    -going home clothes for you and Eli
    -slippers (or something for your feet so you don't have to go barefoot on the cold hospital floor)
    -phone chargers
    -snacks (in case you deliver at shift change time like I did and they don't get you a meal for like 3 hours! C'mon, people, I just pushed a frickin baby outta my va-jay-jay, I need some calories!)
    -your own pillow (with a non-white pillow case so it doesn't get mixed up)
    -camera of course
    -they usually provide all the toiletries, pads, etc that you will need

    Hope that helps!

    p.s. Having seen the way you labored in Jude's birth, I am confident that you will be able to get into "laborland" and not be too bothered by the environment. Just let Kevin and whoever else attends you be the advocates for the things you want while you do the work of laboring. And if it goes faster than his labor, you shouldn't be at the hospital long anyway! You will do great!

  7. I have had 2 all natural hospital births. I only packed a camera, video recorder and my birth plan for pre-delivery. I loved the birth plan because I waited to go in until I was 2-3 minutes apart (laboring at home is much more comfortable than in the hospital, hands down:). It's obviously hard to answer all their questions during or between contractions or even remember what all to request. I recommend a doula as they will advocate for you and fight those demanding nurses who are more institutionalized in nature... heaven forbid you have one like that, but just in case. I had permission from my doctor to demand to sip water and a delay in an IV hook up as I HATE it so much. I think it hurts less if the IV is put in your wrist-forearm area instead of in the back of your hand where you can feel the hard needle with any hand movement. Also, I requested to remove the IV as soon as I'm moved to the recovery room. I also was told by a midwife that if the hospital wanted/required their 20 minutes continuous fetal heart beat monitoring, they couldn't confine me to a bed and they'd have to stand beside me for the 20 minutes to get what they need (since I like to squat/kneel on a pillow draped between Danny's knees to labor which doesn't keep the monitors in place). I use the Lamaze breathing so I didn't have any other focus objects, but if I was to be there for over an hour, I'd bring a DVD player or an IPOD as background sound so make time go faster and I hear more than just beeping. I brought a snack of cheerios in case I was laboring long enough to feel fatigued... to sneak whenever medical personnel weren't looking. Last, I packed the baby clothes, a comfy robe and change of clothes for post delivery. If you have a crappy insurance plan I'd also pack your pain killer of choice and colace as the hospital charges $4 per pill... and obviously every time a nurse comes in you're billed for the visit. Hopefully, you have good insurance and don't have to think about that. Also, be prepared that if you deliver at a time when the cafeteria isn't open, then you won't get a meal and may need Kevin to make a run. Depends on the hospital amenities. Good luck! I can't wait to hear how it goes.

  8. oh yeah, sometimes I'd watch the monitor to see when a contraction was starting so I could get ready or past the peak to keep me motivated to keep going near the end. I don't use the stirrups when I push. I have Danny hold one leg/knee and a nurse on the other side to push out towards my shoulders while I push. It feels good and I assume it helps.

  9. I had a positive unmedicated hospital birth with Bryson. Some tips:
    1. Ask for a nurse who likes working with moms who are unmedicated. Having a good nurse is SO helpful. Let her know you want to be left alone.
    2. Remember YOU are in charge, you can say no to things you don't want.
    3. Hiding in the bathroom is a good way to be left alone too. They seem to respect that space. So showering or sitting on the toilet are good places to get privacy. But again, most nurses will leave you alone if asked.

    You can do it! Here is a link to positive birth stories, many are hospital ones.