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Thinking about my birthing preferences

I won’t be making a long sheet of birth preferences for this birth. I don’t think a full sheet of text will get read. Instead, I think I will put a few key points on there, and then just communicate what I want as I progress.

I will absolutely start discussing with the midwives my birthing preferences, probably starting with my next prenatal appointment at 20 weeks. I don’t know which midwife will be there to catch my daughter (still weird to say “daughter”!) so I might as well talk about it with all of them.

These requests might sound trivial, and they are in the grand scheme of birthing. But darn it, I am the customer here (NOT a patient. I am NOT sick). If mama ain’t happy, ain’t no one happy.

And let me say first — I do understand that real medical emergencies happen. When they do, I am grateful for the medical expertise that helps the situation. If that happens, I will comply with all that is asked of me, provided that I am given my options if there is enough time.

But I am preparing for a normal, natural, uneventful, unmedicated birth.

For starters, I don’t want to wear that annoying hospital gown to birth in. The nurse insisted I put it on last time (instead of my own clothes) and I was too timid to protest.

But the humongous gown was constantly in my way. It was probably size 3X or more (which I can understand) but I was just swimming in the darn thing. It was hard to keep out of my way when I walked around, went to the bathroom. And plus, it made me feel like a hospital patient.

This time, I want to wear a bikini top and probably a short, stretchy skirt. And if they have a problem with either of those, fine. I will just be naked. I don’t have to look at myself — they have to deal with it. And besides, at a certain point in my birthing, I really did lose all modesty and I didn’t care if a boob was sticking out, or if my heiny was feeling the breeze or any of that. I had other things on my mind!

It would be nice if they let me wear what I wanted. And if something unforeseen happens and they have to wheel me off to the OR, then surely someone could throw a blanket over my giant pregnant self.

Trivial? Yes. I don’t care.

The next one is not so trivial. I do not want a freaking IV! I don’t want a hep-lock/saline lock or whatever they want to call it, either.

The stupid thing in my hand made it so I couldn’t put any weight on my left arm. It made getting in a comfortable position so hard!

I understand that if I accept any type of drug — be it a pain med, induction/augmentation drug, or antibiotic, etc., I will need a line open. So start the line at that time. Don’t start it when I am totally fine.

Because seriously, all good nurses can start an IV line in an emergency, am I wrong? So let’s do it then. Or how ’bout we’re not doing it at all, since I won’t be needing any of those interventions this time.

Next, I don’t want any internal exams until I’m pushing. I think it’s ok for an internal to verify that I am completely open, but that’s it. I don’t want internal exams during prenatal appointments. It doesn’t matter one stinkin’ bit if I’m 0cm and not effaced at some appointment, or if I’m 3 cm. That is not an accurate way to predict when my daughter will be born.

If I know that I’m at 0, I might unconsciously (or consciously) become frustrated. Or if I know I’m starting to open, then I might get extra anxious. Neither are beneficial.

Same with once the birth starts. I may or may not progress at 1 cm/an hour. This seems to be some sort of textbook dilation rate. Do women actually open at this rate? I have no idea. Further, it doesn’t matter. A mom can seriously go from 2 cm to holding her baby in her arms in just a few hours (or less!).

I was so frustrated to find out, after some hard laboring, that I was only 4 cm along. I thought I’d be much further. It would have been better to hear a simple, “You are progressing nicely, well done,” if they absolutely had to check, instead of me hearing that number.

Plus, internal exams while in labor are extra-uncomfortable.

A better indicator of how far progressed a mom is, is just by observing her behaviors. There are definite signposts!

So no, I do not want a bunch of internal exams unless someone can make a darn good case for one.

I understand the need for continuous fetal monitoring once a drug has been introduced to the mom’s system. The drug can have a negative effect on the baby, and the monitor would probably pick up on that. However, studies have shown that continuous fetal monitoring does NOT improve outcomes on babies or mothers! It just leads to more unnecessary c-sections (I can’t hyperlink for some reason, so I will paste one source: http://www.childbirth.org/articles/efmfaq.html).

If I’m birthing drug-free, then no, I will not consent to continuous monitoring. Intermittent monitoring can be done by the midwife or a nurse. Why should I have to lay still for 20 minutes every hour, when there are better, quicker alternatives?

There is an incredibly stupid rule at the hospital that doesn’t allow laboring moms to eat or drink anything but ice chips. Maybe some water, too. Or clear fluids. Either way, it’s really dumb and unfounded.

The idea is, stomach contents could be aspirated if the mom needs immediate knock-out surgery, and the anesthesiologist screws up. But see, not eating or drinking at ANY point in time cannot guarantee that the stomach will be empty, or that aspiration will occur.

Get in a car wreck and are unconscious and need surgery? They aren’t going to say, “Well too bad, we don’t know if he has food in his belly or not. We don’t want him to aspirate!!”

The stomach will still contain acids, which can also be aspirated and is MORE dangerous than if it were diluted by food.

Anesthesiologists treat surgical patients as if they do have a full stomach, so they make sure their techniques will protect the patient.

So yeah, let’s starve and dehydrate the laboring mom. She doesn’t need energy. Just pump some fluids into her IV. No risk of fluid overload, or her blood being thinned, or her oxytocin and other birthing hormones being diluted, or her blood pressure being affected, or her baby artificially gaining water weight, or an annoying, uncomfortable IV in her arm. Yeah.

Instead, if I am thirsty, someone had better give me what I want to drink. And if I’m hungry, well then, bring me my snack bag. I will sign whatever waivers they want to throw at me. But do NOT tell me I can’t have anything to drink or eat.

When it comes time to push my baby out, I don’t want to be told how and how long to push. I can see why a mom with an epidural would need help. But I can feel what’s going on. I know what to do. Let me do it on my own, unless there’s some reason I need to be sped along. Better for baby and better for me.

What else can this demanding pregnant lady possibly want? One more thing, and it’s a biggun’. I do not want to be separated from my baby. If I cannot accompany her to whatever procedure or bath or whatnot, then I am sending Shane.

Last time, the nurse wanted to give Johnny a bath in the nursery. I wanted Shane to go with, to ensure that he would be brought back promptly, to see how she did it (maybe get some tips!) and to make sure he wouldn’t be given a bottle or paci. The nurse told me no. She said that if we did, then ALL the parents would want to go with their babies for a bath.

She seriously said that.

Again, I was too timid to speak up and say that didn’t make any sense.

This time? Yeah. I’m going. Or Shane is going. And if they’re not cool with that, then fine, no bath for the baby.

I also had to send Johnny to the nursery for a heel-prick test or something of the sort. He was gone for 45 minutes. I was starting to get some serious anxiety — WHERE IS MY BABY?! GIVE ME MY BABY NOW! — and I was heading out the door to go look for him, when they wheeled him back.

I’m guessing they held him for awhile so they wouldn’t bring a screaming babe back to his mom. But you know what’s great for screaming babes? THEIR MOMS.

Can I say for sure they didn’t give him a bottle at that time? I just don’t know. Cuz he was awfully quiet and content after having that heel prick. And he wasn’t interested in nursing for awhile after that.

It’s not to say that I think the hospital staff is out to sabotage me and my baby. Far from it! I know they have a job to do. I know they probably aren’t thrilled with people like me, who want things that aren’t the hospital norm.

But I’m the customer. I’m the mom. And I don’t think I’m being unreasonable.

Ideally, I won’t show up to triage until I’m about ready to push. I figure the less time I’m there, the better, even if that means I’m puttering around on hospital grounds for awhile. But I also know that plans can change, and I could be there well before I’m pushing.

We’ll see what the midwives say to my requests. I will ask that they put them in my file, and speak up on my behalf at the birth so that I don’t have to deal with any confrontations. Shane will also be well-versed in my wishes, and will be my advocate.

I am not anxious about giving birth, but I am anxious about being in the hospital!

And why not a home birth? Well, I don’t want one. Our insurance covers most of the hospital birth and our expenses will be just around $300 — prenatal appointments and tests and ultrasounds included. It’s too cheap to ignore. The insurance won’t cover me at the birth center or a home birth and I don’t want to pay out of pocket.

Plus, I do like being in a hospital in case something is needed — especially since it will be winter and I don’t want to be ambulancing my way across town on icy roads.

Can you relate at all or am I totally out there? What sort of things did/do you want to have your own way, instead of the hospital’s?