Buy the hospital ticket, go for the hospital ride

by Réka Morvay on September 23, 2009

hospital birthOne of my favorite blogs to read belongs to Navelgazing Midwife who came up with the very apt line in the title.

When you buy the hospital ticket, you go for the hospital ride.

So many women walk away disappointed from their hospital experience, feeling let down. The reason for this is that they went to a hospital with certain ideas of what a hospital birth will be like, but in the end, their birth ended up being very different from what they had imagined, or what, in fact, the hospital had marketed to them as being possible.

Very specifically, if you would like a natural birth experience, a hospital is a landmine of obstacles standing between you and an intervention-free birth. In many hospitals, “natural” simply means through the vagina, but does not actually exclude the use of IVs, pitocin, or vacuum/forceps-assisted delivery.

Let’s put it this way: if you wanted the experience of a leisurely picnic of fresh, home-made food in a meadow, you wouldn’t walk into McDonald’s to get it.

That means that when you choose to give birth in a hospital, you either accept the menu of routine interventions that they do, or you accept that you will have to fight them every step of the way to be allowed a birth that’s different from their routine. Don’t be naive enough to think that in a hospital where they always restrict a laboring woman to bed, you will be allowed to walk around. Don’t think that in a hospital where they believe that every mother needs an episiotomy to “save” her perineum, they will let you go uncut. Even if you manage to convince the nurse on duty when you arrive that you’d rather forego the usual enema and shave, at best, you’ll probably get a reputation as a difficult patient along with some poorly hidden sneers, and at worst they’ll patently ignore your request and tell you it has to be done whether you like it or not.

So how to have the kind of birth you want?

KNOW your hospital’s routine, KNOW your doctor’s practices, and don’t be afraid to switch if they don’t match with what you want.

In Hungary, routine hospital interventions include the following (and by routine I mean they always do it unless you manage to birth quickly enough so they don’t get the chance):

  • 75-90% of first time mothers receive an episiotomy
  • 25% of mothers receive a C-section
  • 6/12/24 hours to “produce” a baby after your water breaks (depends on hospital, practitioner, circumstances)
  • 7-10 days after your due date before induction (sometimes less)

Depending on the hospital and/or the doctor/nurse on duty, the following are routinely performed in most hospitals:

  • enemas
  • pubic shaves
  • continuous fetal monitoring
  • IV upon admission
  • being restricted to a bed during labor
  • being restricted to your back during pushing
  • feet in stirrups
  • baby isolated after birth
  • baby taken away at night
  • father not allowed in the post-partum ward

I can’t stress enough the importance of visiting your hospital, both the labor ward where you’ll be laboring and giving birth, and the post-partum ward where you’ll be spending the 3-5 days after your have your baby, and asking the staff in each some hard questions about what they allow and what they do not allow.

Similarly, ask your practitioner what his or her episiotomy rate is, and what his or her C-section rate is, and do not take “I only do X when it’s absolutely necessary” for an answer, because that tells you nothing about how often he or she considers a given intervention necessary – it may be 9 out of 10 cases, or only 2 out of 10.

And I recommend you read Navelgazing Midwife’s post by the same title: When you buy the hospital ticket, you go for the hospital ride (or why most birth plans are useless).

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