I wonder if you can refuse to give your social and use a false name? I’m just curious as well how it works. |
| I am preparing to deliver in a hospital in Philadelphia. I asked a nurse at my practice about support people; the policy as of now is people who went through their associated prenatal care are 'registered' to deliver at the hospital and can have support people. The hospital will not turn away laboring women who arrive at their door (obviously) but those people cannot bring in support people. She didnt say this but given proximity to NYC I suppose they are worried about overflow. |
Actually, statistics do point this, in Europe and in the US. Also, you can’t compare US homebirth to Europe. It’s comparing apples to oranges. Midwives in Europe are highly regulated, unlike in the US, which has a 3 tier system of midwives ranging from ones who are trained and competent, ie CNMs, who ones who are not at all, ie CPMs and lay midwives. The studies that show how “great” European midwives are are done in countries where midwives are fully integrated in the health care system, where there are standard, strict, and widely held protocols for women who are eligible for midwife care and the get screened for it (and it’s only low risk women who get midwives so it’s not high risk women like women trying for a second VBAC or twin births like CPMs routinely do here), the midwives are highly regulated and held accountable by professional governing bodies (again, not the case here for those who are not CNMs—MANA is a joke and their midwives don’t meet international standards of midwifery) and protocols for when transfer to hospital becomes a necessity, unlike here when CPMs dump women at hospitals and leave because they have no relationship with the facility and lack training to even practice there. Unfortunately the CNM community is closely aligned in the US with the CPM/CM community and that means a lot of ideological blur about natural birth makes its way into CNM curriculum and philosophy. This is all problematic for women and babies. |
| It is unusual for women in Europe to be attended by OBs. This is only for serious emergencies. Women are delivered by midwives, in hospital or at home or at the birthing center. |
Great, so we should all just move to Europe for our births. |
|
"Planned out-of-hospital birth was associated with a higher rate of perinatal death than was planned in-hospital birth (3.9 vs. 1.8 deaths per 1000 deliveries, P=0.003; odds ratio after adjustment for maternal characteristics and medical conditions, 2.43; 95% confidence interval [CI], 1.37 to 4.30; adjusted risk difference, 1.52 deaths per 1000 births; 95% CI, 0.51 to 2.54). The odds for neonatal seizure were higher and the odds for admission to a neonatal intensive care unit lower with planned out-of-hospital births than with planned in-hospital birth"
https://www.nejm.org/doi/full/10.1056/NEJMsa1501738?query=featured_home |
NP. Very helpful article -- thanks for posting. Effectively says overall risk of complications is low, and absolute difference between home and hospital births is small; but likelihood of obstetric procedures is higher in hospital. They also briefly discuss ways to improve midwifery system in the US. Seems like US has chosen to involve more obstetric interventions across the board to achieve a small improvement in outcomes. |
| NYS overturns NY Presbyterian's "No Support Person" policy: https://www.cnn.com/2020/03/29/health/new-york-hospital-childbirth-policy-overturned/index.html |
|
How do women labor in hospitals in the US? Do you just walk around the hallways? Are the hospital beds low to the ground so women can easily get in and out as they need to -- to walk, squat, stretch, so the OBs and midwives can help them with various laboring positions?
I had my 2 children in Europe (we are from Austria) in a maternity center so I am trying to picture a hospital birth situation. We are thinking about a 3rd who might be born here. |
I suppose it varies depending on hospital, doctors/nurses, and health of patient. I have given birth at two US hospitals in different parts of the country (we moved across country in between our two kids’ births). Both times, I went into the hospital after contractions had started at home, was admitted and taken to a “laboring” room and stayed in that room and in the hospital bed (couldn’t get up and walk around as I had an IV and fetal monitoring device attached) being attended by nurses until I was dilated to a 9 and almost ready to start pushing, then they quickly moved me to a different delivery room and the doctor rushed in at the last minute and essentially was just there long enough to “catch” the baby and sew me up (I had an episiotomy both times). My labors were relatively short though. Under 6 hours for the first baby and under 4 for the 2nd. I think if I had been in labor longer, I may have been allowed to be up and walking around. |
| You’re technically allowed (pre-pandemic) to walk the hallways before you get an epidural (if you do) but the nurses also want to have you hooked up to the fetal monitors for a certain amount of time each hour. I think there are some more portable monitors, but if you need an internal monitor because baby is in a bad position, you’re pretty much stuck in bed the whole time. |
I had my first DD at a local hospital with a hospital-based practice of CNMs. I was hooked up to an IV (ended up needing an induction) but I also had a wireless fetal monitor, so moving around was no issue. Labor/delivery room was large, with a tub. I could get into and out of the tub as needed, but I wasn't allowed to actually deliver in the tub. I moved around freely up until the point that I got the epidural. Once I was fully dilated, the midwife suggested I labor down for an hour, then I was assisted in delivering while laying on my side (didn't want to deliver on my back, as I had been told that upped my chances of tearing). Very pleasant experience. Repeating it again (hopefully) in a few weeks! |
|
Previous poster here (from Austria) This is interesting. I am a little surprised at the "allowed to " language -- isn't the laboring woman in charge? I did not have any monitors -- the midwife just listened regularly on her stethoscope. is that the right word? Epidural in not common at the maternity center. I think those are for emergencies. I need to check with a friend who delivered in a hospital back home. I delivered lying mostly on my side both times and my midwife guided out my son. It was so painful but by the time I was pregnant with my 2nd son i had forgotten the pain of the first one -- well, almost!
I need to do more research. |
| My DH was zero help during both labors. He watched TV. I didn’t want to be talked to and the nurses were great. Please don’t stress about it. Just have your healthy baby. ❤️ |
No one cares. |