Water Birth? Births at Home? Hospitals Births ? Hear from a Nurse Who’s Seen it All

Giving life to the next generations of humanity, who grow up nestled under our hearts, is a dear subject to me.  While I grew up in a family with all females giving births in hospitals, having done my homework and followed my heart I had chosen home birth, and even more… water birth! :). Last year, after giving birth to Sprout, I blogged about WHY I CHOSE HOME WATER BIRTH in detail.  Shortly after delivering Sprout I had many questions (as well as some unhappy comments :( ) coming from Vegalicious readers, answers to which I did not have.  Fortunately, I know someone (a nurse) who works in the maternity ward and has seen about everything there is to see about the BUSINESS OF BEING BORN IN AMERICA.  I asked this wonderful person to tell Vegalicious readers more about what the rest of us might now ever find out otherwise.  So, grab a chair, a cup of tea, and get ready to become a fly on the wall of an American Maternity Ward!

(Since the person I am interviewing would like to keep his job, I will keep the real name out of this article. We will call this person Nurse X :).)

water birth

After you read this interview, make sure to also watch THE BUSINESS OF BEING BORN video!  It is eye opening and helped Hubby and I in our decision making process.

Water Birth? Births at Home? Births at Hospitals? Truth Behind the Secrecy

(emphasis added by Elena)

I have been a labor and delivery nurse for 6 years. I love my job. Helping deliver babies is the most wonderful sight, next to seeing your own bundle making an entrance into this world. I hope that however you decide to deliver your baby, you do what is in the best interest of you and your child’s health in mind.

Most days at my job are enjoyable. Other days are pure, well, you know… I, and some of my friends, see doctors that we shake our heads at. Some will let a woman labor too long only to do a Cesarean hours later, because that poor woman needed relief. Others will push for one so they can go home for dinner. The two biggest things you will here in these cases are: “The baby’s heart rate is too low”, or: “You aren’t progressing like you should”. My favorite is: “Your cervix is swelling”. When we hear that, we roll our eyes and think: “Yeah, right!” As nurses, we have no choice but follow doctors’ orders. I’m not saying that all of them are unnecessary, because some truly are lifesaving.

Many women do not realize that a Cesarean section is a major surgery. In rare instances after having one, women bleed too much and have to go back into surgery for a D and C*. If that doesn’t work, they are bound for a hysterectomy. Sadly, I’ve even seen patients die from such complications. There were instances when we had pastoral services not only come in for the family, but for us also.

I commend anyone that can to do a home birth. At home, you aren’t rushed into having the baby. Your body does what it should and when it should. And if it doesn’t, you have a midwife that will get you the medical attention you need. You are allowed to change positions, walk, be in a tub, etc., in the comfort of your own home. You may be able to only do a few positions in the hospital, as long as you are on a monitor, or until you are numb from an epidural.

Birthing plans at most hospitals are accepted within reason, but believe me, most of the staff members roll their eyes at them behind patients’ backs. In our department and across the nation, doctors have almost an unwritten policy about birth plans too—if a woman has one, she usually ends up with a C-section. When a patient comes in with one, more often than not, one of the first questions several staff members ask out of earshot is: “When is her section?” I think most of them feel they are being told what to do, and they don’t like it. Some things are reasonable, but due to hospital policy, some are not an option, like keeping your baby and/or significant other in recovery after surgery, should it be necessary. We had a patient once who came in with a 20-page birth plan! Mostly the plan was plain demands. She was the most unpleasant patient we ever had and, believe me, we still cringe when we think of her. And… she did get a C-section, which was a medical necessity.

While a lot of women can, there are some women who should not attempt a home birth for a various number of reasons. If any of you have not seen The Business of Being Born, I suggest you do. A very eye opening documentary! My firm belief is, if you are healthy and want a home birth—do it. However, discuss your plans with your doctor. If he or she doesn’t support it, find another doctor who will. Many don’t for fear of liability. That and most insurance companies won’t pay them if they let a patient do home birth. I suspect is has something to do with liability also.

Midwives are highly qualified. You have to have a Master’s degree in nursing to be one. And home or hospital birth, your nurse is the greatest asset you have. She is your champion and stands up for you in the times of crisis. Unfortunately there are some who are there for the paycheck and that’s it.

*D and C: Dilation and curettage (D&C) is a surgical procedure in which the cervix is dilated and a special instrument is used to scrape the uterine lining.

water birth video

Vegalicious Readers Wanted to Know

Jennifer: I would like to know more about water birth and why it’s discouraged by doctors. Why the upswing in C-section births, and more about their feelings/insight on natural birth!

Nurse X: Doctors don’t do water births due to sanitary reasons (not my words, theirs); and for legal—if something were to go wrong, they can be sued=more liability. The increase in C-sections is due to doctors wanting to go home after a long day at work, or if patient is not progressing like they want. Increasing pitocin can cause heat-rate decelerations in baby and result in an emergency sections as well. I like the natural way best, because there isn’t the stress on the mom or the baby as in an induced or hospital birth.

AlisaM: I’m curious on his/her opinion on VBAC* and HBAC** and what kind of negative effects they’ve seen induction/ medical intervention do on mommas and, especially, babies (aside from the obvious—C-section).

Nurse X: VBAC and HBAC can be tricky. Depending on who you are also dictates if you can have a VBAC. Nurses working in delivery/mother unit have a greater chance than the general public. The negative effects of induction can be respiratory distress in infants, sometimes in having to be resuscitated. Very scary if you haven’t ever seen it. The mother can have excessive bleeding, or end up with a hysterectomy or even death. These are rare instances, but they do happen. I am not a fan of how the labor seems rushed. On the flipside, doctors in residency can and do let women stay in labor up to 48 hours.

* Vaginal Birth After Caesarean

** Home Birth After Cesarean

Joanie: I would love to hear an opinion on HBAC. I recently had an emergency C-section after laboring at home for 36+ hours; next time I would like to try a home birth again.

Nurse X: What was the reason for the emergency section? There are so many factors before I can say for sure. However, if a person has had a section, I would feel more at ease if they were at a birthing center rather than home. I live in a rural area and I know it can take emergency responders more time to get to her. Time is precious. Each time the uterus is cut into it becomes thinner. I’ve seen women after 3 surgical deliveries have such a thin uterus you could see inside. We saw the baby’s ear and hair before the incision!

water birth at home

Kimmie: Why do they encourage formula and tell new mothers their babies aren’t getting enough from breast milk, so they have to supplement? Just curious because I have heard a handful of people tell me this but my lactation consultant said it’s impossible for babies to not get enough from breast milk.

Nurse X: I’ve not heard that about supplementing with formula at our hospital. We encourage breastfeeding and especially skin to skin contact at birth. As long as the mother is eating properly, baby should be getting the right nutrition. Formula stinks going in, and it certainly stinks coming out. My motto is: “Forget the rest. Breast is best!”

April: I would love to know the difference in *process* of a water birth with a midwife at a hospital versus at home. The hospital here has the option of water births, but I would imagine there is still a difference in process.

Nurse X: Since we don’t do water births, I can’t comment on first-hand knowledge on doing it at home or a hospital. Home would be more comforting, it would seem to me. But if you did it at the hospital, you don’t have the expense of renting the tub or having to clean it.

In Conclusion

I love being a part of birthing babies. It’s the rush, rush, rush of getting them out that I don’t care for. Kudos to those who are able to do water births and use a midwife. I advocate for the patient their wishes. Any patient under my care I will laugh with, cry with, and pray with. Every live baby I wish a happy birthday and pray they have a happy life. It is a joy to work with the moms. It’s the staff that has become numb and listens to what the medical establishment dictates what we do.

I have so much more to discuss, but my fingers are sore from typing. If you have questions, please post the under this post and I will do my best to answer them.

Sprout | Birth Story from Leslie + Dane on Vimeo.
 

 

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  • foot patches

    foot patches There are certainly a lot of details like that to take into consideration.

  • Devi

    This is a great article. I had few questions:
    1) Let’s say you opt to go with a hospital birth and you request the doctor that they wait for like 5 minutes before clamping the baby’s cord. Is this a common request? Is it totally upto to the doctor whether they agree or not? Or is their answer based on some hospital regulation?
    2) I know you can opt out of taking epidurals etc. Both my sisters had their kids without it. But one my sisters, when she was in labor, the doctor said that her contractions were not coming in strong enough considering that she was already dilated 5cms or something like that. And they put her on pitocin. In a situation in like this one, does the patient and spouse have the right to say they don’t want the drug? And that they would like to continue naturally for more time? I’m all for medical help if the situation really warrants it and I was wondering if this example qualify as one.
    3) Nurse X said that doctors push for c-section saying stuff like “Baby’s heart rate is low”. Is there anyway to actually determine they are saying the truth? Or another one “You’re not progressing the way you should”. These cases where c-section is being recommended, does the patient have the right to say no?
    I guess I’m quite confused about the extent of patient rights etc.

    • Devi

      I had one more question please:
      4) Why do hospitals say women in labor cannot eat or drink until after delivery, but at home you’re free to do so?

      • http://www.vega-licious.com/ Elena

        Devi, I will send your questions to the nurse, but a couple of them I can answer myself, while you are waiting.

        1. Not very common, since people do not feel like they can challenge (or even know that they should ask for it) doctors or nurses. The doctors also feel rushed to move on to the next patient, so you would have to discuss this way ahead of time with your doctor, if you decide to go that route.

        2. You have the right to refuse any drug or treatment you want. Most of the time the assessment is incorrect and the woman is rushed to dilate faster than they naturally would, because doctors are rushing out to get home or to the next patient. Believe it or not, I was not checked even once, until I was in active labor, how far I was dilated. I was in labor for 27 hours before my midwives came, so, no one looked up my hoo-huh to see what is going on, etc., my body knew it, however and I did just fine. You have the right to insist to go natural as long as you need to, even though they might scare or bully you.

        3. I will leave that one for the Nurse to answer, but I can tell you that once you hear that as a parent, you will not question it much, since you will only be thinking about your baby’s well being

        4. you can eat and drink, but at some point, because of your labor you might not want to. Interestingly your body will make you discharge pretty much everything that it can before the baby comes, so you do not have to worry about “going” while in labor on anyone or yourself.

        • Devi

          Thanks Elena! It was good to read that you weren’t subjected to the dilation examinations. I think they checked my sis 3-4 times and she was in a lot of pain. I don’t think they thought they were doing anything wrong, it was just part of the procedure for them. Though I really wonder why do that, coz my sis said that eventually she started having the urge to push and she was fully dilated. The staff could easily wait until then to confirm.

          I totally agree with your point #3. I don’t think anyone would think twice if they are told their baby could be in danger. That’s what makes it so sad that doctor’s would take advantage of that. I knew that C-section rates in the U.S were high, but I never realized doctors push for c-section for ridiculous reasons. I was pretty shocked when I read that if someone goes in with a birthing plan, they almost surely end up with a c-section. I sincerely hope that’s not the case everywhere. Few years ago, a friend of mine was saying that his wife had 2 c-sections and apparently lot of his friends also saw the same doctor. Apparently they had an inside joke that whoever went to this doc ended up with a c-section! But the funny part is, they thought it was kind of a jinx that if you went to that doc, you would end up NEEDING a c-section. They never thought that the doc is probably doing c-sections when not needed! I would have avoided that doctor like the plague.

    • http://www.vega-licious.com/ Elena

      Devi, here are the nurse’s answers:

      #1. Though delayed cord clamping isn’t a normal request, if everything has gone well I don’t see why an OB wouldn’t honor the request.

      #2. Patients at any time can request not to have any helpers for contractions. Doctors will encourage it tough. Sometimes being able to move (walk, etc) can help.

      #3 If baby’s heart rate goes below 120 and stays down for more than a minute, it can be a cord issue and baby should come out. Sometimes the cord is up around an arm or the neck and contractions are pushing the baby so it will cause a dip. If it stays down, we know there could be trouble. There are times when labor stalls. Depending on how long one has been in labor and the physician can dictate if the patient will be able to wait a little longer before suggesting a Cesarean. Patients can always say no, but sometimes it is the only option if labor
      has stalled too long.

      #4 Some hospitals allow a liquid diet. In working in both that will allow a light diet and one that not, our experience is women seem to be more prone to getting sick and vomiting when they are allowed food or liquid. And our patients that eat big meals before they come in, usually have a big meal come out the other end. Remember you do push like you are on the potty. It doesn’t always happen, but it does.

      On the subject of pushing, we’ve had women that wanted to push to early and that doesn’t help. It can cause cervical swelling. This usually happens when the patient has had an epidural.

  • Tandi

    As a homebirth student midwife my experience has been quite different. Most ‘emergency’ c-sections are due to induction, pitocin, woman laying on her back which causes baby to have to birth against gravity, the pelvic outlet cannot naturally expand in a supine position, epidurals interfering with movement of the pelvis & function of the pelvic floor muscles, drop in blood pressure from epidural causing decelerations in the baby’s heart rate and reducing blood supply and oxygen to baby and the list goes on and on……

    . As far as VBAC is concerned it is not as safe in a hospital as it is at home, again because of induction and the use of pitocin as well as epidurals and ‘purple pushing’ which brings with it all the risks of VBAC, at home without those interventions complications are much less likely.

    As far as water birth is concerned, hospitals don’t like them because they can’t control the situation. A woman in a tub doesn’t have an epidural and cannot be ‘easily accessed’ and they don’t like that. They don’t understand delayed cord clamping and all the aspects surrounding a water birth that make it safer for baby and much more comfortable for mom. Hospitals are about efficiency and they couldn’t care less about the patient’s safety, experience or desires…. As long as they stick with protocol no matter what happens to you you will never win a lawsuit against them regardless of what damage happens to you or your baby. Once you get on that assembly line no birth plan is going to stop you from their interventions and the dangerous effects of them ultimately leading anywhere from 33-60% of women to having ‘emergency’ c-sections! The World Health Organization states it should NEVER go above 10% so obviously the majority of the c-sections today are unnecessary, the emergency situation was ‘created’ by intervention and then a c-section occurred. Women do not understand the risks they take by accepting these interventions. As a doula I saw women being lied to in every birth I attended….doctors lied about risks, did procedures without women’s knowledge or consent or just lied to get them to agree. I stopped working with women in hospitals because I never attended a single birth in a hospital where I didn’t see a woman being abused, mistreated or lied to all while she thought the staff was wonderful because they were ‘nice’ to her. Women believe if the doctor acts ‘nice’ he/she is wonderful…..very sad.

    • http://www.vega-licious.com/ Elena

      Tandi, these are awesome valid points and I think they are right on.