If this is your first pregnancy, you may have some questions about what a hospital birth looks like. I am going to try to paint a clear picture for you and offer some questions you may want to consider.
Many couples prefer hospital births and I will admit that many hospitals have taken large strides in the right direction to be more family friendly, there are still many hospitals that have a long way to go, so don't take choosing your birth location lightly. Some hospitals have a better track record than others, ask around in your area to find out where the best places are to give birth and why they feel that way. Your doula can help by recommending her favorite places to go, afterall, we tend to have our favorites to work with.
I often tell clients how important it is to have a care provider that you can trust. There are many OB's and many midwives that offer supreme care. There are also both OB's and Midwives that perhaps are not in the best professional field. You spend a lot of time with these people prior to your birth, *most* of them will show their true colors at your prenatal visits. You *should* be able to get a clear picture of the type of care they are going to provide once delivery day comes. With that said, it's best to get your questions answered well before you even step foot into the hospital or birth center. There are significant differences between hospital births and home births, today the focus is on what a hospital birth looks like.
Triage:
Unless your care provider has called you in, you can expect to spend some time in triage. This is the time of "in between". The hospital is monitoring you, doing some of the admission tests, such as blood work, urine samples, etc. They will check you and your baby, they will ask lot's of questions. If you have a birth plan, this is a great time to hand one out to those caring for you. You will be managing your contractions, this is a time that you will want to plan for while preparing for birth. If you are planning a medication free birth, you will have practiced contraction management methods, so it's best to stay focused on keeping yourself comfortable. That will help keep labor moving. If you are planning to have an epidural, you will still need to have some methods of handling your contractions, and staying calm and allowing the contractions to do their job. I know moms who say triage was the hardest part because the last thing you want to be dealing with is a bunch of questions and feeling unsettled. You may want to have some ideas of how to handle this part of your hospital experience. If it means having your doula with you, then ask her to attend with you. If it means you and your birth partner are armed with techniques like having your music readily available or bringing some lavender oil to keep your mood relaxed. It helps to know what keeps you calm in stressful situations. This is one of the reasons why many parents choose to stay home as long as possible once labor starts. Ask yourself the question, do I want to labor in the comfort of my own home? Or do I want to labor in the hospital? That's a question only you can answer. Some feel better at home, others feel better knowing they won't be delivering in the car, if they wait too long to head in. Repeat after me, triage and transition don't mix :) However, be fully prepared to be sent home if you show up too early. And that's good news if you think about it! More time at home is never a bad thing!
Labor room:
You will be assigned a room and a nurse once it is determined you are far enough along on the delivery path. It will be wise to get acquainted with your new surroundings! There will be blood pressure cuffs, baby monitors, contraction monitors. The monitors can make or break the mood! It's incredibly frustrating to have to have the nurse come in every time you move because the monitors have stopped doing their job, when you plan to be moving a lot, because that's what gets baby OUT! I highly recommend you take special care to consider options as far as monitoring is concerned. Perhaps you can bribe the nurse to come in every twenty minutes with a doppler instead of the continuous monitoring? In all seriousness, I've seen traveling monitors that help a little bit, however, there is still a lot of readjusting. So be prepared for this. Thankfully most nurses are incredibly patient with moms that have a need to move around a lot! So don't let it keep you from moving, even if you are told to stay near the bed, don't underestimate the power of positioning while close to the bed!
The labor room has lot's of lights and mostly they can be dimmed so you can enjoy your dark room, nurses visit constantly, even if you want a quiet birth there will be many many MANY distractions. The beeping monitors (your support team gets rather good at jumping up to mute the beeping) you can have music or TV on, you can walk around the room or even the halls. You are going to be wanting to drink at the very least to stay hydrated, and hopefully have some snacks on hand too. Crackers with honey are a great snack! Popsicles can be great, some hospitals will allow you to keep them in their freezer. Great option! With the eating and drinking comes the bathroom breaks. This is something moms often need to be reminded of. It's a good idea to try to go every 20-30 minutes, especially as things progress. Sometimes baby's head can get stopped up by a full bladder, so you want to keep that bladder empty so baby can keep moving down, down, down.
If you have a doula (I sure hope you do!) this doula will most likely join you once management of contractions gets a little more intense. Some moms choose to have their doula with them every step of the way, some doulas love to do that, however, some don't come until birth is more active and contractions are a little less pleasant. This is great because mom and dad get some alone time to perhaps keep that oxytocin flowing, if you know what I mean! :) (I will note however, if your water has broken by now, there shall be nothing more than touchy feely business!) If doula is there, she will be encouraging you to keep up with your bathroom breaks and drinking and snacking, she will offer to get you whatever you need, she will be walking with you, massaging you while you rest on the birth ball, she will be doing some acupressure to stimulate relaxation or contractions if they are stalling out. This is a period of time that can take hours and hours and hours and hours, but it can also go rather quickly. You just never know. Try to mentally prepare for both a long labor (24 hours +) and a really short labor (6 hours or less). There are challenges that you face with both types of births. The longer labors tend to discourage moms because all of those hours with the hospital staff breathing down your neck is not a picnic, it's like being asked to pee on demand, sometimes it just doesn't happen! Think of ways to mentally allow yourself to relax and open up that pelvis. This is a great time for using visualization. Another thing your doula can help you with, perhaps while dad tries to get some rest! Another great way to try to keep contractions moving is using a breast pump. This is something you will want either your doula or a nurse to help with. The shorter labors are a bit of a whirlwind too. You will have to make decisions quickly and sometimes the hospital staff just starts doing things you haven't consented to because they haven't had time to soak up your birth plan. Think of things that are high priority and have those in bold print or readily available if needed, share those with your husband, because your doula can't speak for you, but your husband sure can!
How often will you see your care provider?
Care providers are rarely seen a lot throughout labor. They are often close by and check in with you and with the nurses, but they are not going to stay in the room until baby is practically crowning. This is something that surprises some parents, what you will want to do is get along with your nurses, if not, it's acceptable to respectfully ask for someone else. They are going to be the constant presence and even they pop in and out of your room because they have other patients, but you will want to get along with them. Are you delivering with a group or are you delivering with a midwife? Will your OB be the one at your delivery? If not, have you met all of the on call care providers?
The "time clock":
The truth is, you are on a time clock the minute you walk through the hospital doors. More so if your water has already broken. There are some care providers that try to be patient, but if your baby is not tolerating labor, or you start to show signs of infection such as fever, etc, they are ready to act. These are the times that you have to consider realistically. This is when it really helps to have a care provider that you trust. You need to trust they are doing what they think is best for you and though there is still some room for consent, a lot of times there are few options at that point other than to get baby out. This is the gray area of hospital births. I would like to believe they want what's best for mom and baby, but there is the blaring fact that they are trying to avoid lawsuits. It's a double edged sword.
Pushing stage:
This can happen two ways, if you have not had any medication, you should be able to feel when your body is pushing baby out. A lot of moms say they can't control the pushing because their bodies do it without any coaching. There is something to be said about allowing your body to tell you when it's time to push. A lot of times that happens around the same time that you are fully dilated, however sometimes it takes a little time. Let your body lead. Nurses are not used to seeing this happen, their instincts are to coach you to push once you hit 10 cms, just remember most of them mean well! It's exciting for everyone to see a baby emerge, even those of us that have seen it many times before!
The other side of pushing is with an epidural. There are positions your doula can recommend with an epidural in place, and most of the time there is the option turn the epidural down or off, so you can feel the sensation to push. These are great options to be able to push effectively. Otherwise, you will most likely be coached and they will do the whole count to ten in one breath thing and it can move quickly or it can go on for a few hours. Consider what this looks like to you.
After birth:
If you have not had any pitocin up until this time, don't be surprised if the hospital tries to push a round of it after the baby is born. There are studies that show it's effectiveness, and there are studies that look down on this practice. The theory of the hospitals is that it will reduce the risk of hemorrhaging. Read up on it and make your decision as to whether you will allow it or not. It's one of those "sneak in's" that they try to do while your guard is down and you are busy with baby. Also, if you have had no medication and you need to be stitched up from tearing, be sure to let your OB know more than once that you would like to be sure you are numb down there before they start stitching. Nothing worse than having those blissful moments skin to skin with baby after delivery and flinching and grimacing because you are feeling the stitch work down below! Ouch!
Thankfully most hospitals have adapted to allowing mom and baby to have skin to skin and some even do the delayed cord clamp routinely, as long as baby is doing well, you can expect to spend the first 30-60 minutes soaking your baby in while he/she rests on your bare chest. (You will want to make sure these are standard procedures at your birth place, if not, be sure to add it to your birth plan and talk to your care provider about your intentions) The staff or doula will find a blanket to cover you to keep you both warm. This is a really sweet and special time. Your doula is probably snapping pictures by now and keeping you company when the baby needs to go for weight and apgar checks. You can expect this to occur in the same room as you, but it doesn't hurt to ask while on the hospital tour just to make sure.
You will stay in labor and delivery until you are showing signs that you are ready to "graduate" to Mother/baby. Mother/baby is the room you will live in until you are discharged from the hospital. You may or not be surprised that during this time, there has been some rough "mashing" of your belly. This is not pleasant, but it is something they do to ensure your uterus is clamping down and shrinking. It's also a way to monitor your post partum bleeding. Some nurses are more gentle than others, most of them hate doing this to their patients. Along with the bleeding, you will be given some "mesh panties" to wear. They are really stretchy and I can say they are pretty comfortable, though not everyone will agree! You are free to make your own judgement :)
Mother/Baby:
This is a time baby usually gets to room in with mom. There are times that baby can go to the nursery, if it's requested or if there are routine procedures that need to be performed. If parents really push to not be separated from baby, they usually attempt to satisfy these requests. You will see a lot of medical staff faces while in this room. The OB checks in, the nurses are in and out, the Lactation consultant, the pediatrician, food staff...it might be wise to take notes of who visits and when, so you can keep it all straight if you have any questions. You are usually left to your own devices while in this room. You have all of the supplies needed to change baby's diaper and feed, nurses will be available to assist when needed and they will be coming in to do vitals and check for bleeding, check to ensure your uterus is shrinking, etc. You will just work on feeling good and ready to head home to start your new life!
No comments:
Post a Comment