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Thursday, February 18, 2010

Having a Pleasant Hospital Birth

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For this part of my Journey to Homebirth Series, I want to start covering ways to help your hospital birth be as pleasant as it can. (If you haven't already, be sure to read part 1 and part 2).

Okay, so you are pregnant. You've looked into your options, and for whatever reason you have chosen a hospital birth. However, you want to ensure that your birth experience will go as close to your plan as possible. So, what are some things you can do?

Let's start with choosing a provider. You want a provider that is more or less on the same page as you, that is respectful and willing to listen to your wishes. You want a provider that doesn't dismiss any fears or questions you may have, and one that takes the time to listen to you and talk things over with you.

First, decided which model of care would work best for you. You can read up on the differences between the midwifery model of care and the medical management model of care to see which one you would prefer. Go ahead, I'll wait.

Now that you know which model of care you would prefer, you can start the interviewing process. You should interview several care providers and find one that you feel comfortable with, one that will respect your choices.

Here are a list of potential questions to ask during the interview:

What can you tell me about yourself and your practice?
It is always good to get the general background on the caregiver’s training and education. Finding out about how they practice and what philosophical beliefs he or she incorporates into their practice can tell you a lot as well.

What kind of labors have you attended?
Find out what percentage of the births attended were natural births (no paid medication), vaginal births, or cesarean births. If the caregiver is telling you that he or she highly encourages natural births but has a cesarean rate of 42%, then his or her numbers says differently. Now would also be a good time to find out his or her rates of other interventions, such as episiotomy, epidurals, vacuum extraction, induction, etc.

Tell me more about your practice.
If the caregiver works with other practitioners, find out if you can meet them and what their philosophies are. Ask how often the care provider is present throughout an entire labor and birth. If you are speaking with an OBGYN, ask if they work with nurse midwives. If you are speaking with a midwife, ask is they have a backup physician and what conditions precipitate a transfer to that physician’s care.

When is it decided that a c-section is necessary?
Will the physician schedule a c-section at the first sign of worry, or will he let you start labor on your own? Are VBAC’s allowed, and if so, what is the success rate?

What conditions precipitate labor induction or augmentation?
Find out how long the caregiver is willing to wait past your due date before wanting to induce. Also find out their protocols when it comes to pre-labor rupture of membranes.

What methods do you recommend to deal with labor pain besides drugs?
Will the physician allow/encourage different positions, walking, massage, counter pressure, etc?

How much freedom do your clients typically have during labor?
Does the caregiver allow freedom of movement, or confinement to the bed? What type of fetal monitoring does the caregiver utilize? Will mom be able to eat/drink/move/use the bathroom/use the shower or tub as she pleases? Is the caregiver comfortable catching the baby if the mom is pushing in an upright position?

Have you worked with doulas before?
If the physician discourages the use of a doula, or has reservations against working with them, that might be a sign that he or she isn’t as supportive of your choices as he or she may seem.

Tell me about the benefits of natural childbirth.
If the caregiver can answer this question in detail, then it is a good sign that he supports natural childbirth.

Finally, follow your instinct. If something in your gut tells you that a certain care provider isn't for you, then keep looking.

Next step: preparing yourself, specifically in terms of writing a birth plan.

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1 comment:

Ash said...

Great post! I've had two hospital births and, while neither was exactly what I expected, they both turned out to be overall good experiences. I felt supported by those around me. Feeling empowered and like you're an active decision-maker can make a huge difference, even if things do not go exactly as planned!