British mum to be waiting to give birth in the USA

[dickiedoodah]

Currently residing in Texas where my husband is completing some military training. 37+1 and am keen to get on with having my first baby. Was hoping to be able to have a natural birth/active labour but it seems this is not the done thing over here. So, my plan is to try and get through as much as possible at home before giving in and going to the local army hospital. I've been told they like to hook their ladies up to monitors and get an IV in when you arrive but I'm concerned this will slow down any hard work I might have put in at home. I haven't done any type of birthing class over here yet, the first and only class is on 14 Sep. I haven't done any sort of hypnobirthing training either have only read one book 'The Good Birth Companion: A Practical Guide to Having the Best Labour and Birth' by Nicole Croft. I've stayed fairly active throughout the pregnancy and so far it's been straight forward so I'm hoping to keep on top of my breathing and use some G&A for the pain.

I'd be interested to hear from anyone who might have wanted to labour under the British system but who ended up doing it stateside slightly differently than planned. I haven't written a birth plan but have made my husband aware of what I don't want.

There was a thread maybe last year by a Mner called southsea something who got stuck in the States whilst heavily pregnant....let me see if I can find it for you.

Here is part of it.

Thanks Purple, will have a read now.

I am in the Caribbean and have private healthcare that follows the US system. Births are Obstetrician led as opposed to midwife led.

I was very lucky in that I had a wonderfully understanding OBGYN. I studied hypnobirthing and informed him that I wanted minimal monitoring during labour and wanted to move around and use the bath whenever I liked. I had wanted a water birth but as a surgeon he wouldn't deliver me in a pool so we had to compromise. He was happy for me to labour however and in whatever positions I wanted with minimal monitoring but once it came to pushing, he wanted me in the position where he could best get the baby out with minimal damage to my lady bits. This would be on my back with legs in stirrups.

Admittedly, I find the whole lying on back thing ridiculous and had I been able to sit up I probably could have used gravity to my advantage - I had to have a small episiotomy but baby was a very quick birth (5 hours start to finish) and my OBGYN is such a good surgeon that I didn't even feel my stitches, had no pain or discomfort from them and they healed within a week.

I also only turned to G&A for about 10 minutes before they told me I was ready to push. Hand on heart, I would do it all over again in a second and I plan on doing the same thing when/if we have another.

Are you able to speak to the doctor at the army hospital? Perhaps they would have a slightly different approach to a regular OBGYN. As long as you tell them when you go in that you want to be able to move around and not be monitored all the time, then they should respect that. However, if you do decide to have an epidural, they'll obviously have to keep you hooked up to a machine.

I get how it feels expecting to labour one way and finding that it's completely the opposite. I just weighed up the pros and cons and decided that whilst I couldn't have a water birth or deliver in the position I wanted, I got to have my baby delivered by a great OBGYN who took incredible care of my baby and I, gave me great guidance all the way through and stitched like a dream

Hope it all goes well, let us know how you get on and good luck!

A word of warning - check if G&A is available. I had my DD in Georgia in the early 90's, and they didn't offer G&A. I had the choice of an epidural or a painkilling injection (can't quite remember what), which I declined.

They broke my waters when I was in active labour, then hooked me up to pitocin because "once the waters have been broken there's a risk of infection so we want baby out ASAP". And because I was hooked to pitocin, I was confined to the bed, not able to move about at all.

So make a birth plan, find out if what you want will tie up at all with what they are willing to do, and make sure someone is with you who will stand up for you when they try to push you into making a decision.

Having said that, I have friends who had wonderful experiences stateside. Good luck!

Pudgy, thanks for the reply. I asked if I could see a midwife when I arrived but was told she assists with births on a Monday morning or a Thursday afternoon! What are the chances?!! So I told them I wanted to stay on my feet for as long as I could and they seemed to accept this. If my waters break they want me to go in but I think that's fairly standard where ever you are??

oopslateagain, this was also a concern of mine. Is G&A even available over here? I have a breastfeeding class on Saturday and I'll ask then. I'll make my feelings clear again next week at my 38 week appointment so I know exactly what I'm dealing with. Luckily my husband is fairly good at arguing so I feel I'm in good hands and since he's American he'll be able to translate anything I don't understand!!

If you're on FB, there are a few natural birth groups that are USA based. Worth checking them out.

You don't have to consent to any monitoring or intervention you're not happy with. Also, in relation to a comment by a PP about positioning, laying on your back with legs in stirrups is the least effective pushing position, as much as it seems to be common place in the US. So again, do what works for you, not them.

Ok BoobAlot will have a look on FB for them. Legs in stirrups is my worst nightmare, if this happens I know I will have failed to fight my corner. I'm not very good at standing my ground usually but I guess this is the one occasion when I get to call the shots, obviously assuming everything is going smoothly and the baby isn't in any danger.

Gas and air is rarely available in the US. In some states, midwives have been campaigning for it to promote less intervention and active birth. They simply have not heard of it and are very suspicious of mother controlled analgesia. That is why the epidural rates are so high.

Hi Dickie,
I've been lurking on mothering.com for co-sleeping advice, but they seem to cover lots of baby-related stuff from a more natural/AP perspective, and look as if they are US based. You might find some advice and moral support there.

FWIW I had my baby in the UK but had to be hooked up to antibiotics from the start of labour due to waters breaking early. I managed to be pretty mobile/active (up to the point where I had to be induced, but that's another story). Like Pudgy says, see if you can talk to your doctor. Their approach may not be as bad as you fear.

Many congratulations and all the best,

SBx

I have a lot of friends in the US who have had babies in the last few years and some of the things I have gathered are:

• no gas & air - everyone is very suspicious of this

• they want babies delivered within 24 hours of waters breaking - the major London teaching hospital DD was born in starts induction if the baby hasn't arrived after 36 hours (they do start IV antibotics when they start pitocin).

• ridiculous numbers of internal exams from 36 weeks to see if you are effaced/dilated which has zero bearing on when you will start labour and merely ups the risk of infection.

• very high epidural and c-section rates (they don't like instrumental despite forceps often being safer for the mother and baby than c-section).

• a number of my friends have been ready to push the baby out and have been told they need to stop and wait so that the OB can come and catch the baby!

Nowadays there are mobile epidurals (in the UK anyway) where you can walk around, use any position you chose and don't have to be on a permanent monitor.

Thanks Scriptbunny will get myself over to mothering.com and see what I can find out. I think I'm just going to have to have a serious chat with a doctor at my 38 week appointment next week. They must offer some alternative to epidurals?? Really I'm after something that won't cause my labour to slow down and won't make the baby drowsy.

I'm not suggesting that you should go along with anything you are not happy about if there is no medical indication for it, but pushing people into managing a type of labour and delivery that they have little experience of could provoke its own problems. Just something to bear in mind.

I gave birth to DD in California 5 months ago.
I was lucky enough to find a great midwife. But what was really fabulous and enormously helped me have a drug-free birth was hiring a doula. Worth every penny.
No G+A here. I used a tens machine I brought over from the uk in the early stages.
Active labour with minimal monitoring including 2 hours in the hospital's bath.
Stayed at home for as long as possible with support of doula.
Sorry for short sentences, breast feeding and typing one handed! Can elaborate later if you have any questions.

I know what you're saying arghhmiddleage and I definitely don't want to get silly about it! I have no experience of giving birth and sometimes think I'm being a bit naive. I don't want to end up having to fight a team of OB's while trying to cope with contractions!

VintageNancy, I'm wishing I had got my act together a bit better before getting to the stage I'm at. Basically I've left it too late, if I had another 10 weeks to go I'd be tempted to find a private midwife.

I didn't hire our doula until I was about 37 weeks - could be possible to find one still?

If I were you I'd get on a plane back to Britain asap and stay until you deliver.

How they do childbirth is America is terrifying!

Unless you get a private midwife (I've heard they are illegal in some states! [shocked]) you are almost guaranteed to be in stirupps.

Are you in San Antonio? A good friend of mine owns the store Go, Baby Go. She's had two natural births there and could talk to you about your options/etc. I'd recommend visiting her store if you're close by.

The OB is the least of your concerns.

The person that you need to influence is the L&D nurse. The nurse will monitor your labour and steadfastly follow hospital procedures, and recommend your epidural. When you are fully dilated, she will page the doctor who will arrive in time to catch the baby.

You really do need to have a written birth plan. Anything that deviates from the norm should be sanctioned by the college of Obstetricians and Gynecologists.

It will be very difficult to decline an IV. You may be able to compromise on just having the cannula fitted, but no line.

You should be able to stay mobile, even with an IV.

You should be able to have intermittent monitoring, but they will probably insist you are fitted with a belt.

You need to agree limited VEs with the OB and make sure it is on your notes.

Pain relief is basically epidural or nothing. If you want nothing, you have to make sure you can get into whatever position you want, and are not subjected to time limits.

If you want to see what is typical, watch a few episodes of 'A Baby Story". If you don't like what you see, make sure it's on your birth plan.

Take your own food for after the birth, especially tea bags. And take paracetamol too.

Certified Nurse-Midwives are legal in all fifty states. They are as well trained as British midwives.

Just thought of a book that might help you: hospital birth. I found it really useful.

Ugh that didn't work! Stupid phone. hospital birth www.amazon.com/gp/aw/d/1558327185

www.amazon.com/gp/aw/d/1558327185

I am in San Antonio Ants so will try and find that store. Thanks Margery, I wish I could get back to the UK for the birth, what I'd give for the comfort of NHS and a midwife!

Knowsabit is VE vaginal exams? (excuse my ignorance!)After reading your post I'm going to come up with a birth plan and watch some of that 'Baby Story'. I have several pages of positions for the various stages that I plan to take in with me and show them, or get my husband to show them! I was going to take in my birth ball (still waiting for amazon to deliver it) but think they may laugh at me?!

I'm from Texas - G&A is not used in the USA as pain relief and you will likely be offered an epidural upon arrival (90% of American women have one). My sister gave birth in San Antonio last year in a large hospital and had great care for her very quick labour. You will have a medical team and "your" doctor will be there to deliver you - have you got an obstetrician there? You should.

In Austin, there are some midwife-led birthing centres, but I'm not sure about San Antonio. My recommendation to you would to be to get a doula. The US birth system is so medicalised and it sounds like you will need an advocate and midwife-like help in the hospital. My Texas friends have all had doulas - the ones who care about a non-medicalised birth, anyway.

If it helps, Americans are equally terrified of birth on the NHS!! They would never trust a midwife to deliver. There is a strong belief that only expensive private delivery with your own doctor is safe. My mother is absolutely freaked out that I am going to give birth in an NHS hospital and keeps saying I should pay for a private doctor...

Another thing, hospitals are lush in the US though be prepared for costs. Hope you've got good insurance! A C-section is $20,000 without! Please PM me if you want to chat or ask questions.