involved in making decisions during labour?

[kittenstorm]

Did you feel you had a voice when decisions during labour were made? Through a 'normal' labour... About things like monitoring, positions during pushing, vaginal exams, episiotomy - things that are more 'controversial' as in things mum may not want but midwives/obs want to do 'to' you? Did they insist, bully or respectfully listen and agree to follow mum's wishes as long as things were going Ok? Are some things easier to negotiate on and some less negotiable?

Have any of you been able to resist pressure on something you really didn't feel comfortable with/was necessary and how did they treat you after you refused to back down?

Or did they do something you didn't want to happen but they did it without asking when you weren't aware of it, like arom, epis and it was too late to stop them? (but it was essentially done against your wishes)

Again, not in emergencies when things are different!

getting anxious!

Get a doula!

I made decisions as much as is possible I guess. I wanted to go in a pool and did (although DH had to remind me that was what I had said). I was on all fours the majority of the time and was not forced to changed position for monitoring etc. I wanted minimal vaginal exams and only had two (one when I arrived at hospital and one when I said I wanted to push to check that I was 10cm).

I had a very straightforward labour. Make sure your partner knows what you want so that they can speak up for you in case you are not able to.

I'm sure you will be fine.

They wanted too cut me with DD as her head was only part out and I was getting tired, I requested they didn't if possible and she said I have given a local anaesthetic we will give it till that kicks in and see how it's going, she came out on the next push, I found strength from somewhere. So in answer I wasn't asked as such I was told, but they were willing to wait once I asked, had she not come out I think they would have just cut.
With DD I only had one internal when I arrived.

I had a homebirth (not at all meaning to turn this into a 'homebirth is best' thread, btw) and I felt totally listened to and consulted all the way through. I ended up with an epi, but at every step if the mw wanted me to consider something that was not what I'd hoped for in my birth plan she talked me through it. Asked if she could do an internal exam, asked if she could break my waters at 9 cms, asked if I wanted an injection for the placenta. Her timing was impeccable, so the answer to all these things was 'yes'!

I do think you have to go into things prepared to be flexible (and it sounds as though you are), but if I was going to have a hospital birth and I was concerned that would lead to a lack of control over things, I would agree that it's worth seriously considering a doula.

I do want a homebirth for the very reason of having more control, this is 'just in case' thinking/anxiety.

I thnk a doula would be just one more person fussing over me and I want as much privacy as I can get, the more people involved the more stressed I'd feel. That's just how I am. I feel deeply uncomfortable with anyone apart from DP looking at/touching my bits! I know I'll have to deal with that, but I want to minimise it, as well as minimise potential intervention by keeping active, trying different positions, possibly water etc.

I wasn't given any choices at all but then I was already pushing when I arrived at hospital so I guess things would have been different had I gone in sooner. I would have consented to anything but wish they had let me get onto all fours as that was the position I had been in the whole time at home and it was much more comfortable than on my back even with the g & a at hospital! I'm still quite annoyed that I was given 2 ves without being asked as well, it just seemed so disrespectful. I don't mean to scare you by saying that but sometimes you need to be prepared to stand your ground or have someone with you who will!

I am completely happy with the level of control I had over my normal delivery in a midwife led unit in a hospital. Examples:

I had one vaginal exam, performed with my consent.

I was monitored with a pinnard intermitently but was so absorbed in my contractions that I have almost no memory of this and certainly didn't want them to ask me for permission every time! I have just requested my labour notes and it turns out that I was monitored every 15 mins in stage 1 and every 3 mins in stage 2 (which went on for 1hr 35) but this was completely fine with me.

When I got to hospital the midwife asked if I'd like to use the birthing pool, I said I might, they ran it and I changed my mind, and they were completely fine with that.

I generally used whatever position I fancied, until the end when it was taking ages to get DD out and they made suggestions about a change of position, which I was more than happy to take up.

I had a small stitch and again I felt this was handled very sensitively and respectfully.

On the homebirth point: you will still be with NHS midwives (unless you pay for an independent midwife) who follow NHS procedures. I can't see how it would actually be that different to giving birth in a hospital, in terms of your control over the kind of "normal" things you mention. Certainly I felt that although I was in hospital, the midwives were pretty hands off and I would probably have had a similar experience at home. In fact I am seriously considering a homebirth for DC2 (due May), because there doesn't seem to be a real reason to bother transferring to hospital (in my case). But I would actually expect the midwife care to be pretty similar to my experience in hospital.

Good luck with making your decision!

doulas don't fuss. Mine hardly did anything except make sure I pipped the other lady in the birthing centre for the postnatal double ed.

They do whatever you need to get on and labour. Usually this means keeping everyone the hell away from you, as well as themselves if that is appropriate and meets your needs.

Same here, I want a homebirth this time because I want to be listened to.
I had to stay in hospital a day and half this week and they DO use bullying tactics.

Anyway, my first birth in hospital the MW did as I wanted, but afterwards I tried to refuse an exam for tearing but the DR wouldn't listen to me and was horribly brutal.

First time no, 2nd time there wasn't time, 3rd time I was a bolshy stroppy cow and things happened much as I wanted

kittenstorm, I think you may be surprised at the things you don't care about when you're in labour! I can understad about you not wanting people fussing over you, though - I absolutely can't stand being touched when I'm dealig with physical stuff, like being in pain or being sick.

A good midwife is likely to be sensitive to how much contact you want, mine pretty much left me alone and just kind of directed operations and 'coached' me - she was brilliant. Certainly you and DP can make your feelings clear - and definitely prime your DP to speak for you on the matter if need be, as Nevereatyellowsnow says.

Oh, and on your point about preferring to have as few people there as possible - for my DD's delivery I only saw one midwife for about 80% of the time I was in labour in hospital, and she kept popping in and out (DH was there with me). A second midwife turned up right at the end for the actual delivery. And then left pretty promptly afterwards (which was fine with me by the way).

Whereas with a homebirth, ironically, you'd probably have two midwives with you for more / all of the time, and so actually more people attending you than in a midwife-led unit (presuming a normal labour and delivery in either case that is).

I started off with an attempted homebirth but had to transfer after several hours of pushing. I was consulted at every stage at home.

In hospital the atmosphere was a bit different (things were sliding towards being more desperate as time went on). They said things like "we NEED to do this BECAUSE... do you understand? Any questions?" So they were clear. I did say when they told me it was looking like emcs that I wanted them to try anything possible that was left available to me. They were very clear that in their professional opinion, it would not work but they did an epi, tried a ventouse and tried a manual rotation because I asked. They were right, it didn't work. But it was very important to me that they tried. They recognised that.

my doula was my advocate - she made sure everything happened the way I wanted it too - we'd talked through all the possibilities I could think of beforehand

it was crowded in the room lol but we made the second mw sit in the kitchen

I planned a homebirth, and at home felt very much in control and listened too. The midwife only suggested things to me, always asked if I wanted her to do a VE etc.

Had to transfer into hospital after 24 hours at home, and almost immediately got into an argument with a hospital midwife who wanted to break my waters. She was very pushy to the point of bullying and my DP really had to put his foot down to get her to back off. She then went off in a huff and didn't want to deal with us anymore!

The rest of the hospital midwives and doctors we saw were much better though, gave us options and respected our choices - I felt advised rather than railroaded.

Like ShowOfHands I found the atmosphere very different at the hospital - not that my situation was an emergency, just that the balance of power had very much shifted out of my favour. I felt a lot more passive.

I agree with wigeon. I have had a hospital birth and a home birth. For both there was only one MW who sat quietly in a corner, and occasionally checked the baby's heartbeat with the doppler thingy. Both times the MW was very hands off, making the occasional suggestion (change in positions, did I want an exam to see how I was doing, etc.), which I was free to take if I wanted. For the actual delivery a second MW was called in, again, the same in both cases. We had to leave the front door open for the homebirth 2nd MW as my second stage was quicker than expected.

DH and I really liked all the MWs we had and never felt pressured. I guess we were lucky?

Cheers, that make me feel less anxious! I will make DP very clear on my wishes, and it can be his contribution to the birth since he can't do it for me :)

but surely they can't do VEs if you tell them no/resist! they wouldn't hold you down for one I hope!

hastingsmum Sounds awful. I guess they want to make sure all is alright, but he didn't need to be brutal :(

Legally they can't do anything without your consent, it's assualt as much as if someone in the street tried to do a VE on you.

You could always make very clear in your birth plan that you'd like to avoid unnecessary VEs and want to be consulted before anything is down. I think birth plans that are very specific about how things are going to go are a bit pointless, but ones that give a general feeling for the kind of birth you want are useful. Gives the medical staff an idea if you're a "throw everything you have at me" type of person or a "minimal intervention, consult me on everything" kind of person.

Had an IM at home so knew her well enough in advance to be confidant that she would only suggest intervention where there was a genuine need. Always felt listened to and respected.

Friends who gave birth in big hospital units had pretty mixed experiences in this regard.

I had all four of my births in hospital and although the first wasn't so good (I was very young and a bit panicky) I felt completely in control in all of them and well able to make decisions and get my point across.

My last labour was at 23+5 and the first obstetrician I saw tried to tell me they wouldn't help my baibes at birth. Having been on bedrest for 9 weeks, I had other ideas and insisted on speaking to a neonatologist, which ended up happening during my very quick labour and in between gas and air during contractions. I managed to convince him, so I must have been pretty coherant.

I have had numerous hospital stays during my last pregnancy and this pregnancy is difficult. I have never felt bullied by hospital staff at any point. I have felt a little fobbed off at times, but that is easly rectified when they realise you know what you're talking about.

Yes I did, and of course the more you know, the better.

Its so hard first time around, as you are naturally very scared

my only advice is to inform yourself on EVERYTHING and dont have a rigid idea either way, as you never know what will happen. be open to all, and good luck. so if you are planing natural birth, dont beat yourself up if you dont manage it.

second time I did the 8cm rule (I made this rule up!) , when I am SCREAMING for pain relief if I am less then 8cm, then have an epidural as hours of pain aint great. If 8cm plus, hang on in there as baby nor far away

I did it epidural free second time, and it was a good birth. BUT There is no way I could have coped with that pain for hours on end, if that makes sense? So knowing I was 7cm, made me able to hang on in there

I would also advocate having a doula, it lifted a big weight off myself and DH having her there.

DH was able to concentrate on getting me drinks and mopping my brow, holding my hand.

The doula was great at massaging my back in just the right place, but she also acted as my translator to the MWs. So when I said to the doula mid-contraction "is she f*cking kidding me?", doula was able to convey the message rather more politely to the MW that I didn't appreciate her vetoing my choice of birthing position!

The doula was also essential in my case to convince me to have an episiotomy (which I really didn't want to have) when DD was stuck in the birth canal and not going to get out any other way.

Nothing was done without my wishes, but there were times when it was clear things were going to happen whether I liked it or not. All of the MWs I encountered were calm, not bullying, but focused on safe delivery of the baby i.e. their objective, not how I might feel or want to be treated in the interim.

Could DH have played the doula's role? I honestly don't think so, much though I love him. And as for me, I just went so far "into" myself in order to labour and give birth, I wasn't capable of rational speech or thought.