Monday, August 14, 2006

Who wants a ticket to this ride?

I've was blog-hopping a couple of days ago and came across an essay on Navelgazing Midwife, (one of my favorites) titled "When you buy the hospital ticket, you go for the hospital ride." I was endlessly fascinated by this article, because it basically said what I've heard all my career from hospital-based nurses. When you come to the hospital, expect a hospital birth. It used to frustrate me to hear nurses say, "why do they come here, if they won't do what we say, or if they don't want what we have to offer?" I believed that it was the job of the hospital to offer women choices and alternatives, and one of those alternatives should be untampered birth. After all, that was the lip service they gave. At least that was how I interpreted what they said. Now, after reading navelgazer's analysis, maybe I've been wrong all along. Maybe I should be promoting the beauty and benefits of homebirth and stop expecting hospital birth not to be hospital birth. After all, if I really believed I could have as wonderful a birth experience at a hospital as I do at home, wouldn't I be giving birth in a hospital? I already know that the hospital ride doesn't alter itself except with rare exceptions. I saw that loud and clear with my daughter-in-law's birth. Perhaps I should be proselytizing for homebirth exclusively until women win back their power in the hospital setting. Reading that article made me realize what a fence-sitter I really am. I'm too quick to say that "homebirth is not for everyone" (and of course it isn't) but perhaps what I should really be saying is "why shouldn't homebirth be for you?" After all, if a woman really wants, no epidural, no epis, freedom of movement, eat and drink in labor, family at bedside, no separation from baby, etc. aren't her best chances of getting all that AT HOME? I saw first hand how the hospital doctors and nurses treated birth plans. Anyone coming in with a birth plan and or doula were predicted to be wonderful candidates for a cesarean, and then everyone proceeded to do everything in their power to make sure she would get one (not even concsiously- they were just making their own predictions come true by their actions). The hospital system is extremely PUNITIVE to anyone who doesn't walk the chalk. Get out of line, and WHAM, your'e going to be disciplined. Don't think they can't come up with some scary shit to make you comply. You will comply when they finish with you. I'm not even saying this to demonize hospital clinicians. They do what they do, and when you ask for something different, you take them way out of their comfort zone. They aren't taught how to do untampered birth. Tampering is what they do. Aggressive management is the name of the game. Take that away from them and they don't know what the hell to do. They are utterly dependent on tests, technology, and pharmocology to "manage" birth. Tell them they can't do those things and they freak out. That's where their checks and balances are. Plus, they really believe in the safety and sanctity of those things. Those are their tools and rituals. It would be like a woman asking me to be her doula, but telling me not to use massage, hydrotherapy, positioning, or other tools in my arsenal of comfort. I'd think, "what the hell does she want me to do then?" Anyway, I'd love to hear your thoughts. I think I'm suffering through a paradigm shift or some sort of brain fuck that's going to have me even more radicalized on the other end.


Sage Femme said...

I totally agree!

I've heard so many women say "well they can't make you have a VBAC/IV antibiotics/induction, etc"

Truth is, they will pull out the DEAD BABY card anytime and use it to get you to conform to their belief of what is "right".

I think there's this idea with providers and patients that if one isn't DOING SOMETHING, then somehow they're negligent. :(

Laborpayne said...

Sad, but true. They are not taught to sit the labor.

Anonymous said...

I got to your blog through Navelgazing Midwife, and am really enjoying it. I hope you start promoting homebirth -- though people seem to react really extremely to it. I had my first and only baby at home and it was amazing. All my friends think I'm a lunatic -- but I know my actions are having an impact. One of my friends who was going to give birth with an OB, went with a hospital midwife in a hos. birthing center and had the experience she wanted. And now another pregnant friend is considering the same midwife and birth center. (The midwives c-section rate is 17%! Though it's better than the 32% city average.) I really want her to have a homebirth, but it still seems so extreme to her. She's only 3 mos preg. though, and willing to read anything I give her, so I'm hoping by the time nine months rolls around, she'll be staying at home. It's hard work convincing people who want natural births that homebirth is their best option. It just seems so extreme to almost everyone. -Sarah in Brooklyn

Laborpayne said...

Homebirth is a hard sale, it is extreme compared to the current norm of medicalized birth. But keep up the good work, when people see my homebirth video, they see for themselves that its not so crazy. They simply see a beautiful birth. I have found it to be a very effective teaching tool.

Jawndoejah said...

Wow, it's interesting to hear your perspective on hospital care since you are an RN...and also on homebirth. I have had 5 babies in the hospital, but most interventions have been lessened by my later arrival and by also my quicker delivery than normal. My first was a half day event, and I did eventually agree to an iv, and let the dr. break my water. Luckily, I was within two hours of labor. Because my nurse was very good (even letting me push before I was actually "complete"), I had an easy pushing stage of only 15 minutes. My 2nd birth was awful. The nurse told me to "push hard with my body" and made my husband back up. He was trying to calm me down and slow me down in the pushing stage. I pushed with all my might and out popped a meconium stained baby girl. I tore in a "sunburst" pattern and had a hematoma to boot. All this after my first birth was a one stitch fix. Baby the 2nd time was only 7 lbs 9 oz. Hardly a reason for such terrible tearing. 4th birth the doc didn't show though I warned her how fast my pushing stage was, and I delivered the baby right on the bed with nurses getting the room ready. No one was listening when I said, "hey, ring of fire here." That time I let them give me an iv, and she almost killed me with too much drip of fluid (I had baby in less than 2 hours and had 2 bags of fluid after drinking constantly). Finally, with my 5th baby, I did what I wanted in the delivery room. I showered, I drank when needed...didn't eat because I wasn't hungry. I had my baby with nurses catching because it was too fast again to get ahold of the doctor. I think women go through the classes to deliver a baby, and are given information, but not told how they can control what's happening. We don't have to have an iv, frequent monitoring, medication, we don't need to be induced. So far, I've not had to consent to anything drastic. I've not felt pushed too much. However, I think it's because by the time I come to the hospital, I've got about 2 hours before baby comes (except the first time with about 6 hours). I labor most of the time at home and am so glad I do. I actually feel an obligation to go to the hospital now to give the nurses the experience of a non medicated birth. Last time, the nurses were quite amazed I had never had any medication and rarely anything more than an iv. Now, I just have to stand up next time and say no to eye ointment...and tell them I want my baby on my tummy right away. I've had issues with meconium every time and they have taken baby to the nicu once. Last time baby was in my arms within minutes, but she had volumes of meconium (older), and they suctioned her.

Oh, I've rambled on (easy to do with 5 hospital births). What is your suggestion for meconium births that are clearly older mec (I think my bp at the end of pregnancy or fruitful contractions for days may help with that meconium)? My wee ones have it and have to be taken to the warmer and monitored rather than be dealt with on my belly. Could they let them stay on belly when doing interventions? Or is this too hard? I never think about it until later, but would love to be the table, so to speak.