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.

Hi PeshwariNann

I'm in the process of trying to find a Doula. I'm not sure how it works over here with the number of people allowed in the room when you're in labour?? That's probably something I'll need to check with the hospital before I decide on anything for definite. The hospital I'm booked into has a brand new labour unit so I'm sure everything will be pretty nice. Luckily due to husbands job we don't have to worry about medical bills. Am shocked at the price of a C-section without insurance! Hope your NHS birth goes to plan, good luck with it all.

A good book is Ina May Gaskin's Guide to Childbirth. It is all about natural labour and birth from a pioneering USA midwife. I read it loads and when in labour was able to use lots of her stuff including getting my Doula and DH to press on my hips as I squatted to open my pelvis for delivery, asking for a spoonful of honey to give me energy during second stage...

I also had a Doula and would highly recommend plus reading and making a birth plan and discussing with the OBGYN. I had my DS in the uk, natural water birth. Am now in Caribbean and under USA type system, am trying for second and prepared to fight my corner to get a natural birth and not deliver in stirrups with IV line etc if I get pregnant again and deliver a second child here. They have gas and air here but not in the USA I fear. Really recommend reading and going in with plans, knowledge is power! Good luck.

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

I think that is a bit scary! I watched US OBEM and I actually thought the US system much better. There were no women screaming in pain, whenever anyone said they were in pain, the midwives rushed off to get the epidural adjusted and the midwife who gave birth was the happiest of all the OBEMers - not like the exhausted traumatised ones in UK OBEM

Hi Dickie - great to hear you have good coverage! that's the main concern in the US! I think most hospitals are fine with doulas, but I would call the labour ward just to be doubly sure. Thanks for the good wishes! I hope your birth goes really well - and smoothly!!

The USA system is insurance led and risk averse. OBGYNS pay premiums of over a hundred thousand dollars each year to practice, and are scared of being sued hence why they want things their way. However, being able to argue for example that pushing in stirrups means pushing uphill and makes gravity work against you and baby means you can go in empowered. Avoiding bright lights and intrusive internals means you have more chance of natural birth hormones making you labour more effectively. Seeing each contraction as a process you climb through until you get to the top of the mountain and meet you child means pain is less scary. Good support from someone you love can also help you relax and labour better so brief your husband and Doula if you have one. Not just what you want but why you want it. My DH was very supportive once he understood the science about oxytocin, the logic of natural birth rather than assuming medics always knew best.

You really,really do need to talk to your OB before you go into labour and get specific agreement on each point that is important to you,negotiate before it all starts! A reasonable person should understand and listen to you.

Good luck.

I second the Ina May Gaskin suggestion. She will provide a good counterpoint to the medicalised aspect of US care and your doula will likely know all about her!

ushy- but it's not just about during the birth. Of course they are not in pain if they've had full epidurals!

But what state are they going to be left in afterwards with haggered fanjos from giving birth in the wrong position?

Thanks for all your replies on this, I've found everything really useful. Napdamnyou- I've ordered the book you recommended today so should be reading it by the end of the week. This morning I've written my birth plan and have spoken to a doula who we're planning to meet sooner rather than later. My DH is on board with the doula idea, I'm hoping he might be able to be around for some of the meetings before the birth so he feels involved. The doula is familiar with the hospital I'll be giving birth at and has assured me they are very doula friendly and try to accommodate women who want a more natural experience. I'm feeling more positive about the next few weeks now.

Margery but it's not just about during the birth. Of course they are not in pain if they've had full epidurals!

Epidurals appear to marginally reduce perineal trauma. Slightly more likely to have an instrumental delivery but less likely to suffer spontaneous severe tears. It is a bit of midwifery/NCT myth about the fanjo problem.

Great stuff. Remember, the more you know the better and the better the trust between you and those with you during labour, the better. At least you know if you do need medical interventions they will be well practised and top notch! Meanwhile here is is a good article about Ina May Gaskin

www.thesunmagazine.org/issues/433/oh_baby

And here is her site

www.inamay.com/

I wish you peace in your birthing and joy in your child.

You also have to think about the time after the birth.

If you are having a boy, it might be assumed that he will be circumcised within a few hours.

If you don't want this, both you and DH have to be very forceful and vigilant.

Many US hospitals are 'baby friendly' - they will support and help you to breastfeed on demand and have rooming in. A military hospital may be a little behind the times.

They also typically put silver nitrate in the baby's eyes before it is even out of the birth canal. Say if you don't want this, and get DH to remind them at the time.

Wow. Didn't know that about circumcision and baby eyes. Am quite shocked. What else do they do that is different to UK?

Oh just found this explanation on US babycenter

www.babycenter.com/0_what-happens-to-your-baby-after-delivery_182.bc?page=1

Hi Knowsabit, I'm intrigued by the silver nitrate thing. Haven't heard about this, what does it do? Yeah, I'm pretty ready for the circumcision situation. I'll pop it on my birth plan that I do not want the baby whisked away for the snip.

I just found a good birth plan thing when I was clicking round US BabyCenter, looking at differences in birth in USA to what I had in UK.

assets.babycenter.com/ims/Content/birthplan_pdf.pdf

It's really making me think hard about having a baby here in the US system of insured healthcare, if I have a second child. My NHS water birth at home looks like it would be hard to replicate a second time!

No wonder my OB here looked surprised when I said I caught my own baby and he swam into my arms then latched on, and then we all got into bed! No wonder he blinked when I looked puzzled at the 'when we tell you to push' comment he made - nobody told me to push, my body just pushed! It's just so different to the USA stirrups man delivering baby while mum does what she's told model. And when I said I had no VEs during labour or pregnancy he didn't seem to know what to say!

I wonder if it is worth asking the OB you see how many unassisted and non medicalised natural births he has seen, because it seems that many OBGYNS just have very little experience of anything other than the medicalised lying down etc etc USA norm.

Wow Napdamnyou that sounds like an amazing birth experience! Yeah, I got a strange look when I asked for an appointment with a midwife at the hospital here. I was also told that it's a teaching hospital so residents would be looking after me but I'd be interested to know if any of them have actually seen an unassisted birth.

Also, the birth plan is a really good template. Think I'll incorporate it into my own.

Hi there dickie, sorry I haven't read the whole read, just your posts, am too sleepy!

My British sis had DC1 and DC2 in Houston, the first in Hospital, the second at home. Same doula both times, she was wonderful, and also happened to be a qualified European midwife. DC3 was a UK home birth.

She found her first doctor assumed she'd want an epidural/CS etc, and was already leading her down a medicalised path even tho she was low-risk. She changed docs (or OBGYN or whatever they call them over there) quite late in pg, the new doc was happy to work with a doula, and saw no reason to intervene unless circs changed.
She had a normal birth for DC1, just G&A, minimal monitoring and intervention, but this was largely down to the doula as the HCPs were pushing for more. They also wanted her to progress faster (she had a pretty speedy 7 hour labour as it was!), and the doula helped her and her DH insist that she be allowed to labour at her own speed.

For DC2 she did very successful Hypnobirthing at home, no pain at all. For DC3, some pain, but easier than DC1.

You're welcome to PM me if you'd like more details. Good luck!

Another quick note, Dickie - though it sounds as though you have everything sorted!!

A friend who gave birth in the US recently, but who's now giving birth here (her husband's English and they've moved back) has told me that giving pitocin to speed up labour is standard practice in US hospitals, even if labour is well-established on its own. Make sure to ask about this.

Hi Peshwari, thanks for the heads up on pitocin. This is another little treat that has passed me by! Have just been reading about it and it sounds like something I'd definitely like to avoid. Seems they'll give you anything to get you on a bed and hooked up to a monitor! I'll add to my long list of things that I don't want!

Hi again, feel like I'm stalking this thread but your whole investigation has prompted me to look at USA maternity care and practice because of my TTC number 2 plans out f the UK so thank you for the thread! Anyway, during my nosing round the internet I found all these USA birth stories which I think give a good insight into different experiences in the US so maybe you could have a look and pick up tips and ideas from what other women have experienced.

www.babycenter.com/birth-stories

Thanks Nap, I'll have a read of these. Am 38 weeks today and trying to stay as active as possible to encourage the baby to put in an appearance over the next 10 days! In between the hoovering and cleaning of floors, I'll have a look at the birth stories and see if I can find any inspiration. Good luck with your investigation.