What’s wrong with a hospital birth?

[KO2018]

I’m first time pregnant, 18 weeks, and the whole idea of giving birth is starting to become more real.

There’s lots of things I don’t understand.

In my mind, it is a medical procedure - like having a major operation - and I was prepared for being surrounded by doctors and nurses and all the specialist equipment money can buy. Painkillers available as needed. For me this is a reassuring picture.

My local labour unit looks like a spa - it’s all ambient coloured lights, even actual fake candles?? The rooms are like hotel suites and they are always posting things about the power of your body, and how women know more than medical practitioners about what their body needs.

Come again? This is in complete contradiction to everything I have known and been told about medical care up until this point.

I guess I don’t understand - what is the problem about having a hospital birth or an epidural or frankly anything else that might make me feel safe...?

(This is a genuine question I am quite open to changing my mind but I feel like I am missing something)

Hi @formerbabe it’s okay, I don’t mind about the lethal comment. I’d rather go in with eyes open and realistic expectations.

And thanks @melisande99 I also feel the same way about privacy - supremely unbothered! It’s nice to know I’m not a weirdo.

So yes I am nervous but I’m not exactly dreading it. I’ve done yoga and mediation for a quite a few years so I feel like I might at least have some control over how I feel in my mind? But yeah, beyond that I’m happy to let it be what it is. I’m not expecting any kind of birth plan to go to plan anyway!

I actually don’t think I mind where it happens in the end, just as long as it is done safely.

Plus it turns out the groovy spa bit is right next to the hospital anyway so who cares I guess :)

Nothing wrong with hospital for me! Felt much more relaxed on labour ward than guessing all was ok at home. (I worked in hospital before and I don’t know if this is why but for me has positive associations) 4 normal deliveries. 3 epidurals, only mild regret is doing without epidural for 3rd delivery, but once it was over it was done.

Women can have very strong polar opposite views on childbirth. So I’d say hospitals trying to cater for variety of patient expectations!

I’d agree feeling relaxed as possible is ideal but I’m relaxed knowing there is an operating theatre nearby

PS whilst a fan of hospitals, I did birth hypnotherapy CDs (helped up to a point) and dimmed light when labouring.

@formerbabe

Of course they are, that doesn’t equate to “fucking lethal”. The key word in your sentence is “potentially”. The maternal mortality rate currently stands at 13.4 in 100,000 births which is hardly lethal or even high on the risk scale

Yes @vinyldetective I have said I should have added the word potentially. As for your statistic, imagine how much higher it would be if we didn't give birth in hospitals or centres with medical facilities available.

Of course it would. I’m the last person ever to suggest that a clinical environment is anything but beneficial.

I do understand your perspective OP as I also feel comforted by the presence of doctors, equipment etc. I was very lucky though that our MLU is right next to the labour ward at a large hospital. I debated where I'd like to go but decided on the day MLU as could transfer over if there were any complications or wanted an epidural. They did have a spa type pool room but I wasn't that keen on the pool after loads of research and gave birth in a room that still felt very much like a hospital room but just a bit nicer and more comfortable - more like I'd imagine a private hospital room to be like!

It does make sense that we our bodies birth better in calmer, more private settings because of oxytocin etc. That said as others have pointed out, if there is a complication or baby in wrong position no setting is likely to help that baby come out.

My take on the epidural and other inventions is that there is research linking this with increased need for forceps, EMCS etc. As others have said this could well be correlation rather than causation ie a difficult presentation may cause more pain and requirement for epidural but also have a greater chance of needing assistance in theatre. On the other hand an epidural for example often requires that you lie down in a less optimum position for birthing and I don't know if you can feel the urge to push in the same way (I have no personal experience of this so this could be nonsense)

My pushing stage was very active and I did most standing up and delivered that way and was really struggling while on the bed. The pushing stage took a little while and I think had I needed to stay on the bed forceps etc would be much more likely which I believe also can increase risk for shoulder dystocia etc.

That said some women may find an epidural gives them some control back and they are much more able to birth when they aren't wild with pain. I remember feeling that way and was certainly asking for one as I found the pushing stage very hard and that I desperately needed some relief to get some focus. It was too late though by then to have one but I'm glad now that I didn't, although am absolutely open minded to it for my next birth which is imminent.

I'd prefer to avoid c section most of all for loads of reasons but it could be on the cards due to my baby's position, so for all that I believe a natural birth with minimal interventions is optimal, obviously you have to do what is needed on the day.

I actually quite enjoyed giving birth with my second which was a water birth...but I think part of the reason I felt comfortable was that the birth centre was part of the hospital.

Sorry I didn't want to scare anyone. I just think we often take for granted in developed countries that we have access to doctors, hospitals and medicine and we are actually pretty safe.

This is a brilliant website going through different options for pain relief during labour www.labourpains.com/home

As for epidurals - I am an anaesthetist who spends a lot of time on labour ward and who has heard every nonsense going about what epidurals do and don’t do. There are defined risks which we always explain prior to doing an epidural but there are a myriad of studies of hugely varying quality that link epidurals to just about everything. Correlation and causation are not the same thing as highlighted up thread.

I would strong advise having a look at the labour pains website in advance and knowing the options that are available to you as they can vary from place to place.

@allfurcoatnoknickers ‘Cracked off my tits on medical grade heroin’ 😂. That sounds like what I want! I just want all the painkillers because I am a wuss!

@countbackfromten That’s reassuring to hear.

@KO2018 I am also 18 weeks with my first and am just starting to think about my options. I think I’d like an epidural and a hospital birth. I’m not knocking anyone else’s choices at all but for me, the idea of a hospital with medical professionals just makes me feel safer.

Mammals need calm and darkans place they feel safe to progress in labor without medical intervention. This is just a scientific fact. A hospital environment may feel the safest environment to you, but for many others it is an environment for emergencies, where people have surgery and where people go when they are dying or in pain. Masked doctors and bright white lights and chemical smell and beeping machines can all stop women progressing in labour. If you feel safer with a more medicalised environment that is the type of hospital you need to look for.

Masked doctors and bright white lights and chemical smell and beeping machines can all stop women progressing in labour

They can also save the lives of mothers and babies.

Absolutely. But often an overly medicalised environment can be the root cause of unnecessary medical intervention that has consequences for the mental health and recovery of the mother post partum. I have direct experience of that. I am not at all against a highly medicalised birth through choice or necessity, I believe every mother should have the right to choose an epidural or ceserean. But it should be an informed choice, not one born of fear.

For me. Birth is not a medical procedure no one is doing something to me during birth "I" am giving birth.

I have had 1 positive hospital birth using an epidural
2 homebirths and 1 transfer when homebirth of baby 3 was going slow.

Had I agreed to what the doctor wanted to do with the transfer to hospital (speed up labour artificially) I would have ended up with a c section. Ds was laying in a way that meant he could not get to cover the cervix properly. When he finally moved (8 hours later) he came out very fast (2 pushes) if we had medicalised the birth simply because it was going slower than the guy wanted we would have created a issue.

Op check your local not classes many are run online. Try to work out what relaxes you and read books on this subject.

I have a close friend who has has 1 c cection and 3 hospital births all positive experiences she was happy. That is what we need to aim for a happy outcome for mother and baby

For some of us that will mean as little medical sensation and interference as possible. For others it will mean feeling and seeing the medical assistance as close as possible.

What I really hate is this idea that

1 hospital is the only safe way
2 hospital is only for people who doesn't care about their baby
3 my units are for hippies
4 me units is the best way to go
5 homebirthers are nutters
6 homebirth is the only true way to give birth

The truth is we are all somewhere within that scale. For me this was homebirth at home with dh and a friend. For my friend this was hospital birth with her dh present

We have both managed to birth 4 beautiful babies in a way that we felt good about.

Not was meant to say NCT

In hospital having one intervention can quickly lead to needing more & more intervention. I was sent to hospital for monitoring because my blood pressure was high, the hospital insisted I was induced, then I needed an epidural, then my induction failed, then an emcs, then a massive PPH, in HDU I got HELLP & nearly died. When the induction was started I was 36+5, most likely nowhere near ready to go in to labour, they increased the iv hormones to more than double the amount to get things moving & I needed an epidural, couldn't move around to get gravity to help me dilate, I got to 8cm & then went backwards & needed emcs the interventions tumbled & tumbled. I was left with severe pnd & ptsd. If they had just given me medication for my blood pressure & sent me home to go in to labour naturally or at least be closer to full term, chances are my body would have been ready to go in to labour & I wouldn't have needed the interventions I did & ended up with the mental scars I had.

Mammals give birth in small dark private places Do they?

I thought it was because the best thing you can do when in labour is stay relaxed to produce oxytocin. Lots of people find hospitals scary and I think what the wards are trying to do, is appear more homely and safe for women. It doesn't mean you can't have pain relief if you need it or the appropriate medical interventions. Personally I found being in water really helped and I preferred the birthing centre which takes a more holistic approach. but unfortunately with both of my labours I have ended up with complications, and having an epidural. But my point is don't judge the hospital on their appearance, you might appreciate it when the time comes. And it will not mean you won't receive the best care just because there are fake candles in the room!

I had GD so wasn't given a choice, but labour ward was fine for me, I'd have been more stressed at home. The worst thing about a hospital birth is getting out afterwards. Postnatal wards are hell, and best avoided if you can. I was lucky the second time to get out the same day, but the first time we left in the middle of the second night because it took ages to push the discharge through and I couldn't stand being there any longer.

I'm with you op. Birth to me is a medical process because it involves various hormones and physical effects happening within your body (just as death has various medical stages) and you may need help with the symptoms that arise at each stage. Also, birth tends to be downright painful. And you may need help alleviating that pain. Also, it involves two people whose lives can very suddenly and unexpectedly come under threat.

I gave birth abroad, had consultant led care all along, had the DC in a hospital where epidurals are pretty standard, where they don't let you labour on for hours in case of difficulty but send you for a C-section instead, and where you get to stay in a private room with your DH for about four to five days afterwards, during which time nurses help you to breast feed, will take the baby for an hour or two if you need to sleep, and help you bath and change the baby. It was great!

And most importantly, because you feel so confident in the medical side, and staff respond to your needs, you are able to relax more and have a positive experience.

I picked a hospital which had both. I was low risk pregnancy and chose the spa room/maternity unit for delivery although I was also pushed to choose the maternity unit, but when things went down south, I was transferred to the main labour ward where doctors, epidural, c-section were available. I'm grateful that I had access to all the medical equipment, doctors and medicines that were easily available at my hour of need.

When I had my last antenatal appointment, I saw a woman who had given birth 6 hours ago leaving the spa room was dressed up nicely whereas me, I stayed 3 days in hospital after my birth and looked like I'd been in a car accident. For my second baby, I will definitely choose the labour ward as during your hour of need, you don't notice the ambience, the candle lights and music.

Every type of medical intervention has risks. Whether the likelihood and potential of those risks outweigh the potential likely benefits depends on a lot of factors. For me, with my disabilities, an epidural would be a very high risk procedure so when I needed to go to the OR for a manual placenta removal, I was put under general. For some others, an epidural would be safer.

Many women have medical-related anxiety, in part possibly because pregnant women face higher levels of abuse of multiple types, including medical abuse. Over time, there has been growing evidence that certain simple things like dimmer lights and having a less visually clinical setting reduces anxiety and has other benefits for labouring women and reduces on average the need for more risky medical interventions which improves outcomes for mother and child.

For me - having had one rough hospital birth, one great home birth, one awful home birth, and one good hospital birth, the support of the professional involved is the most important. I like that many settings are taking research on this topic into account when possible, even if it can look a bit silly or feel a bit patronizing to discuss the 'homeiness' of what is still clearly a medical setting.

I had a premature baby, followed by a high risk pregnancy which was also followed by a premature birth, and I didn't see one doctor whilst in labour or afterwards. It was nurses who worked on my boys to get them breathing. The only time I saw a doctor was at the ward rounds in NICU

@derxa

Mammals give birth in small dark private places Do they?

Yes

OP you do whatever you feel most comfortable with, as PPs have said the more relaxed you are the smoother birth is likely to be.

Oxytocin is the hormone which causes contractions, and for your body to produce oxytocin you need to feel as calm and relaxed as possible. If you feel calmer and more relaxed in a hospital setting, then do that.

My birth "plan" was to give birth in the MLU attached to the hospital, as I wanted the more homely setting, within minutes of medical help if it was needed. Just explore your various options and go with the thing you feel most happy with :)

@Leodot I am also a wuss, plus I'm lazy. I was pestering my consultant for a epidural from about week 18. Before I needed a c-section, I wore her down into agreeing to induce me so I could get the epidural immediately and wouldn't have to feel any pain at all.

I am very VERY anti pain. There's a bit in the positive birth book where Milli Hill is trying to tell you that you'll only feel 78 minutes of pain in early labor, or something and I still thought it sounded like too much, hence the tantrums and demands for a epidural