Pssst…this was first published on www.mommasociety.com.
The countdown has started. You’ve got your hospital bag packed and you *feel* ready. But here’s the reality: whether this is your 1st baby or your 3rd, every birth story is different. It’s impossible to know how events might unfold during your baby’s hospital birth.
And as it turns out, a hospital birth often means more interventions. According to Dr. Lauren Jansen at Midwestern State University, this means things like:
- C-section delivery
Sometimes, the interventions listed above are lifesaving. Other times, they can make labor more difficult and leave a momma feeling disappointed or even traumatized by her birth experience.
Having had one hospital birth and currently preparing for my second, I can say that even the most supportive hospitals have tools and protocols that sometimes make it harder to have a “natural” birth experience. If your requests are unorthodox, expect a little push back from the hospital staff.
Here’s what might happen during a hospital birth – along with some supportive tips.
1. You’re Told To Stay In Bed
You know the advice to only sleep on your side (preferably the left) during the second and third trimesters? Well, the rules and reasons are similar during labor.
Bed rest, or the recumbent position, works against your labor. This is because it can lead to:
- Poor contractions
- Slow dilation and effacement
- Prolonged labor
- Obstructed labor, or dystocia
- Failure for baby to drop
Bed rest impacts a momma’s blood pressure – making it lower. And it can decrease the blood flow between your uterus and the placenta. With all this going on, it’s no wonder that bed rest is linked to more pain and a higher risk of c-section deliveries.
Instead of laboring on your back and in a bed, freely move around. This allows you to find positions that make you most comfortable and reduces pain. Free movement also improves blood circulation between you and your baby. For example, in the knee-chest position the hips are higher than the shoulders. This can help position your baby for birth and reduce back pain.
Of course, don’t forget to bring along your the birth ball – it’s notoriously good at reducing pain and getting baby to drop.
2. You Aren’t Given A Choice About Electronic Fetal Monitoring
Electronic fetal monitoring (EFM) is standard care during a hospital birth. And it can be either intermittent – here and there – or it can be continuous.
Recall how free movement is good for both momma and baby? Well, continuous EFM restricts this movement. Restricted movement during labor and delivery and continuous monitoring can:
- Interfere with momma changing positions
- Interfere with baby’s rotation
- Increase momma’s anxiety, which can shunt blood away from the uterus
3. You Forget (Or Are Denied) Food and Water
It might be unintentional or intentional, as some hospital advise against food and drink. Either way, limiting what you consume during labor does you no favors. It can lead to dehydration and increase your level stress.
Here are some simple snacks you can bring along with you to the hospital:
- Dates and raspberry leaf tea – Some mommas swear by eating dates 4 weeks before labor because it can reduce laboring time. Same holds true for drinking red raspberry leaf tea during your second and third trimesters. These foods are good before labor and they’re wonderful during.
- Nut butters – Nut butters are high in both protein and fat, which go far in sustaining your energy. They’re also pretty darn tasty when paired with the sweetness dates! Packets like these are easy enough to throw into your hospital bag.
- Coconut water or coconut water kefir – Coconut water is a natural source of electrolytes. During labor hydration is important. And when it comes to restoring your electrolyte balance, plain water (or ice chips) aren’t so amazing. Aim for a balance of minerals and sugar. And if you can, shop for something made by nature, like raw and organic coconut water. Coconut water kefir is fermented, so it isn’t sweet. But it is filled with minerals and wonderful probiotics that do good things for your immune system.
4. You Get Several Vaginal Exams
In order to see how labor is progressing, you might have several vaginal exams. This is when a nurse or practitioner checks cervical dilation (opening) and effacement (thinning).
The problem with frequent vaginal exams is that they’re often inaccurate. One recent study compared the accuracy of a vaginal exam vs. the accuracy of ultrasound to check dilation. It found that typically, vaginal exams are less accurate than ultrasound – generally about 1 cm (or more) off.
Keep in mind too that how quickly – or slowly – you dilate does not necessary predict when your baby will be born. Effacement matters too.
Besides being somewhat unreliable, vaginal exams can increase the risk of infection. According to one report, seven or more vaginal exams during labor require a longer hospital stay because of antibiotic therapy. Newborns are also more likely to acquire a group B strep infection.
Instead of vaginal exams, you may want to gauge how your labor is progressing with the purple line – or bottom line. Birth Without Fear explains,
This is a purple/dark line that shows up and extends well, to put it delicately, along your natal cleft. Or rather – your butt crack. The line starts at the anus and moves up the cleft. When it is all the way to the top, you are 10cm.
If this sounds a little hocus-pocus, a study published in 2010 confirms that most mommas have a growing “purple line” during labor.
5. You Might Be Induced
A hospital birth means you’re surrounded by many ways to speed labor along, or induce labor.
Pitocin is the synthetic form of oxytocin and it’s often given after insertions for “cervical ripening.” With pitocin you’re more likely to have sudden, painful contractions. This means:
- You’re more likely to receive anesthesia for the pain
- There’s a greater risk of hyperstimulation – where a single contraction lasts for 2 minutes or more
- There’s an increased risk of fetal distress
Because of these risks, induction usually means that continuous electronic fetal monitoring (see #2 above) is required, which has its own set of problems. Babies whose mothers are given pitocin are also more likely to have lower Apgar scores.
6. Your Amniotic Sac May Be Intentionally Broken
During pregnancy, a fluid filled sac surrounds your baby. This sac protects your baby’s head during contraction. One way to induce labor is breaking this sac – otherwise known as an amniotomy.
However, it turns out that breaking the amniotic sac *may not* speed up labor and if anything, it increases the risk of c-section. Once it’s broken, there is mounting pressure to have your baby sooner rather than later. Breaking the amniotic sac also:
- Increases the risk of infection
- Increases the risk of prolapsed cord (the umbilical cord coming out before your baby)
- Increases the risk of fetal injury
7. You Could Be Given An Epidural
When laboring with my first son, I was determined to have a drug-free hospital birth. But with several hours of back labor behind me and hours more ahead of me, I eventually took the advice of my midwives and got an epidural.
From my experience, hospital staff will put the pressure on for pain relief. And without the right support, you might decide it’s your best option. However, an epidural isn’t without consequences. An epidural can:
- Weaken contractions
- Prolong the first stage of labor
- Include pitocin (synthetic oxytocin, see #5 above)
- Interfere with your baby’s instinct to breastfeed
- Interfere with the production of breast milk
8. You May Receive A Catheter
If you get an epidural, chances are good you’ll also receive a catheter – a tube that runs into your bladder, helping to keep it empty during labor.
Like frequent vaginal exams, a catheter increases your risk of infection – meaning you may need antibiotics after delivery.
9. You’re Probably Told To Push On Your Back
Once you are fully dilated to 10 centimeters, you may be told to lie on your back (if you’re not already there) and coached through pushing – push for 10 seconds, take a breath, and push again. This is called the closed glottis method.
But here’s what is important: Once a momma is fully dilated, there is a resting stage.
Contractions may become longer and feel more intense, but they are less frequent. This is a period of time when both momma and baby can naturally rest – even during a hospital birth. And taking this time for yourself also allows your baby to naturally drop.
Pushing on your back through counts of 10 – or the closed glottis method – can mean:
- Your baby receives less oxygen
- You feel more exhausted
- The risk of perineal tear
Instead, wait to push until you feel a “laboring down” sensation and make sure you have the support to choose what position you push in. This includes:
10. You May End Up Giving Birth Via C-Section
With roughly 1 in 3 births given by c-section, it is now the “most common surgical procedure in the United States.”
And even though a c-section birth can saves lives, it’s associated with health risks for both momma and baby. C-section can mean:
- A longer hospital stay
- A longer recovery
- Troubles breastfeeding
In addition to this, c-section exposes your baby to operating room microbes first – rather than the microbes living in momma’s birth canal. This first exposure to microbes is incredibly important. There’s now evidence that c-section increases your baby’s risk of:
- Immune disorders
If c-section is necessary, there are some things you can do to protect your baby’s microbes.
- Ask about vaginal seeding, where a gauze is incubated in momma’s birth canal before the c-section – and your baby is swabbed within minutes after birth.
- Request that antibiotics are given after the umbilical cord has been clamped.