8 Surprising Things to Know about Hospital Birth

Do you imagine what your birth journey will look like?
Perhaps you have a birth plan, or you haven’t hired a doula because you’ve prepped yourself with childbirth education. Sometimes mum’s just like to ‘go with the flow’ so they are not disappointed. Whatever the reason you can be in the know with some of these little tidbits…

1. You need to ask for a water birth before you arrive at hospital

Do you want the option of a waterbirth? Well, the thought process has to start before you even arrive at the hospital. Why? Because only certain rooms are graded as water birth appropriate. There has to be enough space, obviously a bath (or some hospitals blow up pools) & hospital midwives need to be water birth certified. I always go through the benefits and research when it comes to using water for pain relief and birth & also remind couple’s when I am with them, labouring at home, to ask the question of getting that water birth room if it is available.

2. You have great pain relief options before an epidural

Why is it that when we think of pain relief, it’s always the epidural? I think it’s because pain relief is often stigmatized & because of that, education is lacking. Did you know that I have used many other forms of pain relief to help a woman cope with her labour which then results in a birth she was proud of and possibly even avoids the question of an epidural? You have morphine to take the edge off in early labour and usually you can get two doses as time goes on. There is also gas which is my favourite because a mum must breathe slowly and deeply to get the required effect. This, in turn, helps with relaxtion and dilation as well as making those surges easier to get through. Lastly we also have sterile water injections which aim to greatly reduce back labour (which often is a huge source of discomfort for mothers). From a practical point of view the epidural is great for mother’s who are so worn out after days of labour with no sleep and obviously for women who have a c section and can be awake for the birth of their child. They can also make a mess of your natural birth process, so if you want to avoid one, why not try some of these other great options to get you to where you need to be?

3. Early labour support is minimal

When I am working with mums the longest and often hardest part of labour (in my opinion) is early labour. It’s erratic and is individual to each woman. It’s also the worst time for a first time mum to go into hospital if she is hoping to have a birth with low intervention. Unfortunately, women expect to have more practical support in this stage from their hospital & I find that this combined with very little help preparing for labour prenatally means women don’t feel comfortable or safe at home because they feel out of their element.

4. If your waters break you will be asked to come into hospital early

This is often a surprise to parents and can feel overwhelming because often this is how women feel a “normal” labour begins. Naturally they then feel anxious about “Why am I being called in?” Essentially, the main reason is for the hospital to confirm that your waters have broken. They either do this with a vaginal swab test or take a look at the pad that you already will have in your underwear. When I work with mum’s we talk in detail about this option. Because, yes, going in is an option, not a requirement. I ask women to consider the reasons why we are disrupting your labour or possibly the calm before your labour begins. If you are sure that your water is broken and there is no cause for concern with the fluid, then what is the point of going in if you feel that baby is ok and there are no external indicators that baby is not? If a mother’s contractions have not started, I always explain that being calm, comfortable and in a place of privacy is what is going to give you the best chance for your labour to begin on it’s own.

5. Most birth suite’s have birth ball’s, heat packs & ice

Lighten the load in your birth bag. It’s pretty standard for hospital rooms to include a birth ball for movement, sitting and comfort. There is always a way to use heat for relief, so whether that means midwifes provide heat packs, or the use of the microwave to warm your own. As a doula I always bring one with me! Plus, ice is a great distraction, a perfect way to cool down or an easy way to hydrate a tired mum.

6. Your labour has a “clock”

Maybe you have heard of of this term before. The hospital “clock” is essentially a timeframe that is applied to when you should have had your baby. It’s not a literal clock or a preconceived time, but once you are in the birth suite your ‘dilation’ progress is compared to a general timer. According to RANZCOG (Royal Aust & NZ College of Obstetricians & Gynocaeologists) first time mums “Will commonly be at 1 cm/hr for most women in spontaneous labour but may be as high as 1 cm/2 hrs in women prioritising low intervention.” This clock is why I mentioned before in point (1) that going into too early can lead to intervention. So what happens then? This is when your childbirth education comes in handy so you can make the choice as to whether you want to ‘augment’ or ‘induce’ your labour with drugs. Again, all my mum’s have prepared for this eventuality & we have talked in detail about the actual research and reliability behind this clock. It’s interesting to note that when this timeline was constructed it was a) in 1954 b) 96% of women were sedated with drugs c) more than half had an assisted delivery d) only 500 women took part in the study. If you would like to read more, check out this article!

7. Your midwife isn’t with you for the whole labour

When I explain this to parents for the first time it’s probably the biggest and most important realisation for them. It is totally natural for parents to expect that when they reach the hospital they will have an assigned midwife who will help them with positions, breathing and labouring techniques to help them get through their birth. Even more so if you have hired a private OB. When I explain that you will have an assigned midwife, that is also assigned to a number of other women, they are surprised with the amount of time they are actually on their own. The same thing goes for your private OB. He or she may only arrive for your actual birth and in the meantime liaise with the midwives on the phone. Your midwife will come and check on your intermittently throughout your labour. Every four hours, unless decline, you will have an internal examination to check your dilation. Now, can you see the use of doula? I would hypothesize that this lack of companionship in labour is the reason many women are using an epidural. Of course, some women plan to labour with one and that’s ok. But, for those that want the natural birth and who have worked hard to get there, then this is where I find it enters. When a women feels alone and her partner has expended all of his options, women feel like there is nowhere to turn but to remove the pain.

8. You will probably see >6 different people throughout your birth

Does this one surprise you? It does for most. And when I explain to parents who feel like a doula will be a ‘stranger’ in the birth space, I remind them that their birth will be filled with a range of people they haven’t met. So who are all these people? Midwives usually work on a 12 hour shift that circulates, so it’s pretty normal to at least have two different ones. That’s not because you are destined to have a long labour, but because you won’t turn up at the start of a shift, it might be halfway or a few moments before it ends. There will most likely be 1-2 OB’s that visit you during the course of your journey. Not because anything is wrong, but just because that’s what they do and again, they work in shifts so it’s common to see difference faces. Even if you have a private OB, you will still be in the hands of the midwives and sometime your OB doesn’t turn up until just before you birth your baby. When you’re read to push, there is usually two midwives in the room & if you have meconium in the waters or are taking some types of medication, then a paedetrican will be present too. If you have a Caesarean then obviously the numbers will increase. There is about 4 people the ‘baby’ side of the curtain and 2-3 wondering around the room. So, if not wanting an unknown face in the room is your only reason for not engaging me, I think you may realise I’m the only one you will probably know really well by the time you give birth!

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