Maternity Wards are Not Birth Centers
Today I took a tour of our hospital's new maternity ward. They're calling it a “Birthing Center”, which is a very common occurrence around the country. The renovations are great, but overall they are not offering many more options than when I gave birth there years ago.
The fact is, a hospital gives limitations to your birthing experience, no matter what they call it. All around the country, hospitals are trying to revamp the way their maternity wards are perceived, making them look and feel more like a birth center. Make no mistake, they are nothing like the birth centers staffed by midwives.
I have a problem with hospitals trying to present an image of being something that they are not, and here's why. Fancy new equipment, birthing balls, and bath tubs; What importance is all of this equipment if you barely get to use it? Unless you have a midwife who will be present for your labor or a Doula to encourage you to get up between fetal monitoring, the reality is that you might not get to use these extras very much.
Sure, if you're a strong woman who can stay calm and put your foot down while still trying to deal with contractions, it could work. I know from experience that it's pretty unlikely, because most women just can't fight a battle during labor.
Maternity ward nurses would love take the time to help women deal with labor, but they can't. Years ago they used to do the work that a Doula would do today, but it doesn't work that way anymore. Nurses now have to make up for the work that the doctor would be doing if he were present.
Not only that, but they're required to hook women up to the machines more often so that the doctor can look at the sheets of paper when he gets there. That's why the battle ensues when a woman doesn't want to be monitored. The nurses are the ones that pay for it when a woman is “uncooperative”.
If you want to be hooked up and monitored or plan on getting an epidural, then you will not mind it as much. But if you're looking for a natural birth experience, this is the reality.
If you want to be able to get up and move during labor, work through your contractions, use the birth ball, or even the tub, go with a midwife, hire a Doula, or give birth somewhere else.
I had a wonderful natural VBAC at a hospital, but I researched OBs and was clear from the start on my expectations and then hired a doula and wrote a detailed birth plan. I was required to be monitored but got the wireless that could go in the tub. I was very happy with the compliance of the hospital. I was also upfront that I was wanting this and that I would get it if I had to drive across the state to get it. I would recommend the hospital again, if the person had the same OB. Also, I’ve had several friends give birth at small town hospitals and these seem to be more open to natural as they don’t have a person on staff to do epidurals anyway. I wouldn’t say a woman needs to be stubborn during labor, but she needs to be very clear before labor and consistent in her planning and choose a good support system.
Rita, I agree, a good support system is essential. I did not have the same luck in the hospital. In-bed monitoring was required, or so they made it seem. I didn’t have a doula, and looking back, It would have made a difference. I know a lot has changed since then, and I am always happy to hear of a woman who was able to have a pleasant natural birth experience in the hospital.
But, having given birth at home, I want women to know that giving birth in the hospital will always be different than giving birth in an out-of-hospital setting, whether that be a birth center or at home.
I agree with your generalizations to a degree. I’ve been an L&D nurse for nearly 32 years and love natural labor if that’s what the patient desires. I work at a Baby Friendly (which translates to Family Friendly) hospital. It is a award in which we worked hard to attain. Our nurses are required to take ongoing classes in positioning techniques to assist patients in labor. We see doulas sometimes, but most of the time we do play that role. In 32 years, I have never had a physician come to the hospital to labor their patients. That would be unrealistic. We do have a C Section rate, but some of that can be attributed to our clientele. We do the best we can to help a patient attain her goals in delivery.
I guess the message I would like to leave here is that we are not the enemy. Know what you want in your delivery and find a physician who will support you in your goals. Talk about them during every visit and be willing to adjust if it is medically necessary. Really, it’s all about the Dr/Pt relationship. When you get to the hospital, let your nurses know what it you want in your delivery. That’s the first question I ask when I meet new families. I will fight hard to help you get what they want, if I know what it is. Even with interventions (fetal monitoring or an IV) there is much that can be done to facilitate a wonderful natural labor. Realistic birth plans are fine, but there should always be room for plan b or c in there. Most of the birth plans I see are cut and pasted directly from the internet and are not personalized to that specific patient.
I can’t repeat enough for you to choose your physician with your goals in mind!
Thanks so much for stopping by and taking the time to comment. I value your input as a seasoned L&D nurse, and I am glad to hear that you work to give your patients the experience they want. I also agree that care providers are a very important decisions. In my area, care provider options are extremely limited, but it’s still important for women to be up front about what it is they want and how to achieve that.
I agree that Physicians would be extremely unlikely to labor their patients, but many midwives in the hospital are able to do this. So, it’s a very nice option for many moms who want to give birth in the hospital.
What has your experience been in dealing with Doulas? Do you have any tips for helping Doulas to work better with the L&D nurses?