The Hospital “Birth Plan” - Page 2

Author // Molly Remer, MSW, ICCE

Article Index
The Hospital “Birth Plan”
Page 2
Before You’re Admitted
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It is important to note that much of this treatment is different from what you deserve, and that you have the right to refuse any of the above procedures and recommendations. At minimum, what you deserve are what Lamaze calls the Six Healthy Birth Practices:

  1. Let labor begin on its own.

  2. Walk, move around and change positions throughout labor.

  3. Bring a loved one, friend or doula for continuous support.

  4. Avoid interventions that are not medically necessary.

  5. Avoid giving birth on the back and follow the body’s urges to push.

  6. Keep mother and baby together—it’s best for mother, baby and breastfeeding.

So, how do you work around these routines and achieve your desire for a natural birth?

  • Go through the above list and decide which procedures you do and do not want. While you might accept certain procedures, you have the legal right to refuse anything. You might also want to develop a backup plan for how to deal with any unexpected situation that arises.

  • Take an independent childbirth class (e.g. Lamaze, Bradley, HypnoBirthing, Birth Works, etc.) and learn a variety of techniques that focus on trusting your body so that your “toolbox” is well-stocked.

  • Hire a doula, or bring a knowledgeable, helpful, experienced friend with you. It can help to have a strong advocate by your side—particularly if this isn’t a role your husband or partner is willing or able to assume.

  • Never ask permission, but proceed with what you want to do until hospital staff attempts to stop you. (An example of this is eating, or getting up and walking around during labor.)

  • Bring light foods and drinks and quietly partake as you please. Restricting birthing women to ice chips is not evidence-based care.

  • Leave the hospital early, rather than remaining the full length of your allowable stay. This will minimize unnecessary separation from the baby and any additional interventions.

  • Request a nurse who is supportive of natural birthing. Better yet, ask your doctor or the hospital staff in advance for the names of those nurses, and request whichever of them is on duty at the time of your birth.

  • Put a sign at eye level on the outside of your door saying, “Natural birth in progress. Please do not offer pain medications.”

  • Labor at home for as long as possible. If you arrive at the hospital too early, you will increase the risk of unnecessary medical intervention. Once your contractions require your full focus and attention, start heading to your birthing location.

  • Use the hospital bed as a tool, not for lying down.

  • Retreat to the bathroom if you feel you need to get away. People tend to leave us alone in the bathroom; you can use that as your place to focus and regroup. Also, because we are conditioned to relax our pelvic muscles when seated on the toilet, spending some time there can actually relax you and help the baby descend.

  • Use the “broken record” technique: If asked to lie down for monitoring, say, “I prefer to remain seated,” and continue to reinforce that preference without elaborating or arguing.

  • Do not lie down, even if you agree to fetal monitoring. Sit on the edge of the bed, on a birth ball or chair near the bed, or kneel on the bed and rotate your hips during the monitoring.

  • Bring a birth ball with you and use it—sitting near the bed if necessary. Birth balls have many great uses for an active, comfortable birth.

When any intervention is recommended during your pregnancy or labor, remember to use your “BRAIN”—that is, ask about the Benefits, Risks and Alternatives, check your Intuition, and ask what would happen if you did Nothing. If an intervention is aggressively promoted during your birth, you can not only refuse that intervention, but you can also ask, “Can you guarantee in writing this will not harm my baby? Please inform me of the risks and then show me the evidence supporting your recommendation.” A classic example is the recommendation of Pitocin due to “failure to progress.” Pitocin not only increases your chances of unnaturally intense contractions, but dramatically increases the likelihood of subsequent interventions as a result of the risks it introduces. Keep in mind that each and every medical intervention has been shown to increase the use of further interventions. All interventions have potential risks for you and your baby.

A great birth, where you are in control, is possible in any setting—provided you understand your rights, know what to expect and have strategies to protect yourself from unnecessary medical intervention.

Finally, birth is not a time in a woman’s life when she should have to fight for anything. If you feel you are preparing yourself for “hospital self-defense,” that’s a cue to explore other birthing locations and care providers. Also, remember that hope is not a plan. If you find yourself hoping for what you want (rather than simply being confident that you’ll get it), it could indicate your intuition is onto something, and it’s time to take another look at your current birth plan.