American Mums - giving birth US style - what can I expect??

[AnnieLaurie]

I am shortly moving to Seattle and will be giving birth there to my second child.

I have spoken to a few American Mums over here and it seems that midwives do not feature in the States as they do here.

Can anyone tell me a bit about what the care is like in the States/any advice on what choices I may have etc regarding childbirth. Would love to hear some people's experiences.

Have visions of self strapped to a bed with feet in stirrups and lots of men in white coats...!! Do they let you move around as you wish? Do they leave you alone, or examine you all the time? Are they into natural childbirth??

Had quite a bad experience 1st time round with unsympathetic male midwife so am anxious to have nurturing, supportive female environment 2nd time round if poss.

Thanks!

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I'm in New Jersey, so not familiar with Seattle, but will do my best to help.

The Northwest is midwife friendly, and I think that we are seeing more midwives as a nation now than say 20 years ago.

Even if you do find an OB/GYN there are plenty out there that are sympathetic and supportive.

I've had two hospital births one with a midwife and the other was with an OB/GYN.

Really similar experiences. Did hypnobirthing both times, both were respectful of my wishes not to have an epidural. It all will depend on the personality and beliefs of the practitioner. Just remember that here it is common to interview doctors before deciding to see them, you can make appointments just to get to know them and ask questions. Remember here everything is private, which means that they work for you, and if you don't like them you can move on to someone else.

Look for a hospital that has an LDRP (Labor, Delivery, Recovery, and Post-partum) room. They are great, because you get checked in, and they don't move you around, unless you have a C-section.

this link should help you find a midwife www.washingtonmidwives.org/washington_midwives.shtml

Good luck, and am happy to answer any questions.

Just had a look through those links, looks like you will find a midwife that will do home birth, hospital, or birth center in Seattle.

Pruners - that seems a bit narrow mind, to say the least. I had crap midwives and fabulous doctors at my UK birth so go figure.

Thanks for this - will have a look at the link when I get DS into bed and get some peace to concentrate!

I did 1st birth with no pain relief at all and am rather reluctant to be pushed into medication/epidurals too quickly.

Hopefully will be able to find nice midwife!!

Anyone else care to share their 'giving birth in the States' stories??

Yikes - lots of info on midwifes, suppose I will have to get out there and start making enquiries fast!!

Any other American mummies online now with more info?

What about birth plans? Do they exist in the US?

I'm American and nothing would make me give birth willingly in the US system, either!

oh dear - can you elaborate please Expat. Would rather know...

Yes, birth plans exist, I've had one for both of my births. Give one copy to your practitioner, go over it with them. They will leave it in your file. Wherever you give birth make sure you bring one copy for the nurses, and keep one copy in your labor bag just in case.

I had a midwife in the US - a CNM who did all her deliveries in hospitals in place of a traditional OB.

I just made clear what I wanted, and I got it.

I watched a lot of US birth programmes and had a very clear idea of what I didn't want - no counting to 10, noone touching my legs, no expectation to stay in bed, no continous monitoring, no IV etc.

Everything I wanted was reasonable and research based, so not something they could possibly refuse. It's just that they encounter very few people who put in the requests I did.

Do you have Sky TV? Lots of the Discovery birth programmes are American. Seem to be a lot more 'flat on your back with your legs in stirrups and your dad filming the birth' than the UK, but I guess if you're happy for the birth to be on TV then it's OK for the family Christmas Thanksgiving party too!!

Do they have mumsnet in America?

Great. Another thread where people are ranting and bashing giving birth in the U. S. This might have to be the 2nd thread I hide in the history of my MNing.

I'm not in Seattle, but in a suburb of Portland, OR. There are midwives everywhere here. If we hadn't moved when I was very pregnant with DS, I would have had no choice but to have him delivered by a midwife. Even in the dinky little town we moved to in Southern Oregon, there were midwives. They were just already booked by the time I arrived. ITA with the person who said the NW is very midwife friendly.

I was very happy with both my births. They did birth plans. I think they were 4 pages long with choices, room to make requests, etc. I didn't know what to put though, so mine was basically empty, but all the staff had them. I didn't have to provide them. They just had multiple copies in my file. Like I said, I was in a small hospital in the middle of nowhere, but had my own private birthing suite, with a bed for DH, and access to a birthing tub in every suite. There was no expectation to stay in bed, no IV's, no fuzzy booties on my feet, ever. I had 2 natural births, in which nobody ever tried to talk me into any pain meds, or something I didn't want.

After the birth, there was a full-time BFing counselor, and a clinic where you could bring your baby anytime the 6 months after birth and weigh them, or ask questions, if you needed. There were postnatal groups organized, from which, I met 12 other moms who had given birth around the same time. We became good friends, and all of us were pretty happy in our experience, and very few had the experience you see on U. S. birth programs, and the 2 that did, that was what they wanted. Let me repeat again. I was in the middle of nowhere, not a big city like Seattle.

Sorry for the book, just wanted to share a positive experience for you, hopefully to make you feel a little better.

AnnieLaurie-I'll give you my detailed stories, because there really isn't anything to be scared of here.

I was induced with ds1 at 38 weeks due to high bloodpressure that with bedrest wouldn't go down. My cervix was soft and favorable so the midwives thought it would be best for me to be induced.

I went in 8pm on a Friday night, was given Cervadil (name of prostaglandin insert here) That was left in for 12 hours overnight. The next morning at around 8am the midwives broke my waters and started a pitocin (oxytocin) drip. There was a mobile monitor so I was able to move around without a problem. I felt a small contraction at 2pm. At 5pm I was 4 cm and at 6cm I was 10 cm. I labored and pushed lying on my left side, and because of hypnobirthing I pretty much slept through it. Dh was able to catch ds1 as the midwife helped him (to date the best experience of his life) Dh says I closed my eyes for a few minutes, would wake up, push and go out again. I didn't notice that 2.5 hours went by before ds1 was born. No epidural, no episiotomy, no forceps, no vacuum. I had a second degree tear because ds1 decided to wave at the world on his way out. Simple, easy great birth. Had my two day hospital stay in my private room, and all was well.

Due to insurance changes I went to an Ob/gyn group for ds2. Great doctors, open and supportive. My bloody show turned bright red so I called the doctors to let them know, wondering if I should be concerned. They told me to go in to triage to get checked, but most likely all was well. I went in at 8am, a nurse checked me and I was 1cm (had been for weeks) and was checked over. At 9am the OB/GYN on call from my group did a vaginal exam and found I was 3 cm so they decided to give me a room and see how things progressed. So I got a room at 10am and had intermittent monitoring every 45 minutes for 15 minutes. At 12:30 I was 7 cm and since ds2 was having a lot of heart decelerations the OB broke my waters to move things along quicker better than pitocin so I agreed. Ds2 was born at 1:30pm. I pushed flat on my back because ds2 didn't respond very well to other positions as I was laboring. When he was born the cord was really tight around his neck, so it was cut at my perenium. He was fine, and I tore around the previous scar line, but that was stiched up and everything was back to normal.

I'm giving birth with the midwives again in March and I'm really excited.

My birth experiences were both wonderful and I wouldn't have done anything differently.

I will agree that our system is very medicalized, but here's a secret: You can say "No" to anything you don't want. You have to sign consent forms for everything, so if you don't consent, don't sign. Both doctors and midwives can get that "I know better than you do" attitude, just put them in their place remind them that the most important job they have is to catch the baby, and you will take their recommendations under advisement, but in the end you make the decisions.

Sorry this was so long.

Not without reason, dooney.

If your birth was natural with little fight from you, then you were indeed lucky.

I think in the majority of the US, if you go with the default position, you will have a medical birth. Many women are conditioned to think this is a good thing, right from the first AN appt when they are handed a What to Expect while Expecting book (ie - just do what the doctor tells you). HCPs are very quick to tell you the benefits of the medical procedures (and there are many benefits) but don't tell you the risks or alternatives.

You can have a good birth in a standard private hospital - I did - but it is unlikely if you leave it to your HCPs to decide. You were lucky at some point on the way if you really didn't write a strong birth plan.

Thanks Dooneygirl and MKG, that was really interesting and encouraging to hear your experiences.

I will definitely bear all this in mind and make sure I don't sign for anything I dont want.

I'm not against hospital births, would prefer it, just hope I can find a solution where there is a midwife or two with me as well!

My cousin who lives in Seattle had her babies (twins) at the same time as I had DD. We swapped stories. The birth aspect seems to be roughly the same, with the only real difference being the after care. My cousin was amazed that I had homevisits by midwives and health visitors, whereas she had to take her 3 day old twins to see the Paediatrician.

Her experience was that the midwives aren't so involved in the birth, but are the ones who do most of the monitoring antenatally, except when there is a high risk situation, and then one is under the OB/GYN. Just like here.

She had problems with breastfeeding twins and had a lactation consultant who did lots of tests and found that her milk didn't have enough fat (which TikTok commented that these tests were ridiculous). But I told her about my HV pushing formula due to slow weight gain.

So about equal for crap advice.

Love Seattle - best of luck!

I loved Seattle too, when I visited earlier this year.

Hope I like living there as much as visiting...

Guess I am going to be the sole Seattle Mumsnetter, cant seem to track anyone down in MN land so far, who lives there.

There used to be one, but she moved. I am the closest MNer to you. There is a whole thread devoted to MN'ers in the US if you want.

I think that my CNM, and I think it is probaly standard, behaves very similarly to an OB, except sticking to normal births. They will do the same amount of VEs and monitoring, and be happy delivering in lithotomy. There will be a LD nurse doing all the tasks, and she will be trained in the obstetric model.

But what you can do is communicate with your midwife, and tell her what you want. It is harder doing this with a doctor - both from your side and from his. Her experience may be from a more obstetric model, but her training will have included a midwifery model and will probably be very eager to have a patient client who wants that kind of birth.

I know that my American midwife told me that she was very frustrated that most of her patients were not willing to put up with any pain, or didn't trust their own bodies. They wanted her care because she was a truly caring person, but were fixated on the control you get from the obstetric model. They were unaware of risks and cascades because they view these as normal.

All of my friends and relatives in the US had birth plans. All had continuity of care (one med professional-- it was an ob-gyn) throughout the entire antenatal period and at the birth. No stirrups, mobile in labor. Everyone I know had her own own room for the delivery and stayed there with their babies AND husbands/partners for 1-2 days after the birth. I haven't seen these TV programs about birthing in the US, but I'd take them with a grain of salt...

I just had a baby 2 weeks ago in San Jose, California. The experience is v fresh in my mind. There are midwives at my hospital group but not in the centre I was with so I would have had to change my OBGYN and location to have one. I always thought this country medicalized the whole experience f birth and I was determined to have a natural birth. Unfortunately I got to 41+4 and they made me get induced. I wasn't dilated at all and they had measured the baby at 9.7 pounds, needless to say they tried to dilate me with drugs and then manually.... EXTREMELY painful. At this point I had to take the Phentonol and then the epidural. After another 8 hours in which time the baby "crashed" 3 times and the heartbeat was down to 60bpm I had to get a c-section. I never dilated more than 4cm. in the end the baby was on 8.5 pounds and i wondered if they had just miscalculated the due date and if i could just have waited he would have come on his own anyway. i suppose that his health is the most important thing and he is a lovely gorgeous baby boy and i am so happy.

i hope you don't have the same experience that i did but in the end the result is still the same!

My sister had a VBAC in the US 11 years ago. AND she had pre-eclampsia. In her case it started early labour, which had been stopped with drugs for a while, but when her blood pressure started to creep up they just took her off the drugs stopping her labour and she went into it naturally.

She did have an epidural, as it lowered her bp, but she had the baby vaginally and although the baby, a girl, had pneumonia and some lung problems, she was released 10 days after the birth.

I wonder if she'd have been able to VBAC nowadays, though.

I was in labour 24 hours here with my first before giving birth and all my friends and relatives in the US were shocked I was 'allowed' to labour that long and not have a csection.

oh by the way...i do know plenty of women her who got to give birth naturally, even with any pain killers!! I holpe i wasn't too full on you can definitely have natural birth.

Hi Ceelo, no that's fine, good to hear from more people!

From all this info, my main concern is going to be caring for my DS while all this is going on, sounds like they are keen to keep you in longer in the States (3 days as opposed to being kicked out after 3 hrs over here!!)

I am assuming they let you go home quicker when it is 2nd time, and you have to get home to your other kids??