Low intervention / Natural birth possible at Fairfax INOVA?

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Hi-
I'm 31 weeks pregnant and am hoping for a relatively low-key birth. I have been going to the practice of Drs. Andersen, Maanavi, Muasher, Yoon, etc and have been very happy with them. After asking some basic procedural questions at my last appt I've become nervous that my desires/expectations will not be met with this practice and/or hospital. Can anyone share some experiences if they were able to have a more or less natural birth setting with these doctors or at Fairfax INOVA? Specifially, I was surprised that even with my routine pregnany I must have constant fetal monitoring, can't eat or drink, can't take a shower, etc. The doctor assured me that I will still be able to move around as I wish even with the fetal monitoring. Can someone confirm that this is true? I will be taking my birthing classes through DC-Lamaze and when I told the doctor this she wasn't terribly supportive in my choice saying that these classes often set people up to fail. I felt very empowered by my class selection since the philosophy matches exactly what I believe. I live very close to Fairfax and know that it has a great reputation as a hospital, but am wondering if it is the correct place for me. Thanks in advance for sharing your thoughts.

[Anonymous]

I go to that practice and delivered at INOVA Fairfax in January. You might check out this past thread: http://www.dcurbanmom.com/jforum/posts/list/1687.page#7486

I posted the Q before the birth of my baby. I talked to one of the docs and Anderson, Maanavi, et all beforehand about medical intervention and having a natural birth. I was assured that it was my decision, but it is their job to provide a certain standard of care that includes using modern technology, intervention, drugs, etc. when needed. (That was the gist of what the doc told me.) In the end, I did not have a natural birth by any means. I would encourage you to find another practice or a doula who specializes in assisting women achieve natural births if this is what you truly want. IMO, a "normal" doctor's office is not the place to expect such an outcome.

[Anonymous]

Sorry to burst your bubble, but I delivered at INOVA Fairfax for #1 and found that it is very high intervention. Let me say, however, that the nurses were great and I thought they took good care of me and my baby and we are both healthy.

But... if you are having fetal monitoring, the nurses really don't want you off of the monitor. Much of this is up to your doctor, but I think INOVA is used to seeing higher-risk pregnancies and are therefore used to more intervention.

If you want any chance of being allowed to move around, DO NOT let them break your water. Once your water is broken (either when it happens naturally or with their little crochet hook thing), you will not be allowed to get up.

If I were doing things over again, I would not have changed practices or hospitals, but I would have stayed home a lot longer. I thought my contractions were every 4 minutes apart, but when I got to the hospital, I realized later that they were not as strong as the childbirth educator had described as being the time to go in (she said when you have a "frowny face" and cannot smile, that is the time to go in - totally agree.) I also would have told them to beat it when they offered to break my water to "speed things up". Being at home is much more comfortable and all you will do in the hospital is lie in bed.

If you get there and things are not progressing (and your water has not broken), you can always go back home, too.

[Anonymous]

The not showering surprises me--I was able to shower at Inova Alexandria.
Fairfax is very busy--lots of babies there, so you and your partner may just have to be very insistent on what you want.

[Anonymous]

I went on a tour of INOVA Fairfax and they said that you could take a shower, use a birth ball, walk around etc. Maybe that isn't actually the case?

[Anonymous]

Anonymous wrote:I went on a tour of INOVA Fairfax and they said that you could take a shower, use a birth ball, walk around etc. Maybe that isn't actually the case?

I definitely did not experience that when I was there - and I asked (and my friends would tell you I am not a pushover). Maybe it depends on your doctor, but the nurses hooked me up and that was that.

[Anonymous]

From my experience it depends on the nurse, and it really helps if you have a doula or doctor that clearly makes his/her instructions known. Note: your doctor is usually not there for the early portion of your labor. So to take advantage of the shower, walking around, etc -- make sure that the doctor clearly specifies that you only need to be monitored xx minutes out of every hour -- unless they start seeing something troubling. BTW I did sit in the bath at home while in early labor and it really did help. I had to be hooked up to an IV for various reasons and therefore they started monitoring me when they gave me the IV. The first L&D nurse said it was okay for me to take off the monitor and get up and move around, use the bathroom, etc. However when the shifts changed, the second nurse came in and saw me walking around and about had a cow.

I definitely think you need to sit down with your OB and understand what he is willing to do to support your natural birth. Is he willing to give strict instructions to the nurses to support your natural birth -- i.e., only so many minutes of monitoring per an hour, ability to use shower, birth ball, etc.

Good Luck!

[Anonymous]

May I recommend that you watch The Business of Being Born? It definitely has an unabashed homebirth slant, but is nonetheless educational about the slippery slope of medical interventions.

Good luck!

[Anonymous]

While it may not be for everyone, I have decided to labor outside the hospital and then travel there for the delivery. At this point, I do not have any risk factors, so this plan could change if something came up. I am in the process of finding a homebirth midwife to help with monitoring during the laboring.

It looks like a natural delivery is not very likely in the hospital these days. I am sure that I will not feel like fighting the nurses off while trying to manage my own pain.

You could always check in with the midwives at BirthCare in Alexandria.

Good luck!

[Anonymous]

Poster: I am in the EXACT same position as you are. I'm 35 weeks along and go to the same practice and will deliver at Fairfax Inova.

When I brought up the issue of interventions with Dr. Maanavi, she said that the way to insure the least amount of interventions was to labor at home as long as possible. She said the I.V. issue was a hospital issue and not up to the doctors. Is that true? I don't know. In general, I do trust the doctors in this practice. But I do feel very, very rushed when I'm in that office and that they will not sit down and have a personal conversation with me regarding my wishes. The VAST majority of their patients end up with the interventions, epidurals, etc., and that is what they want. So I'm sure that is what they are used to and that is the most expedient way for them to get the babies born safely.

I also took a lamaze class, and to be honest, was a bit disappointed as most of it was general childbirth information. In a 2-day, 9:30-3:30 class, we spent maybe a total of 1.5 to 2 hours on the practicing breathing part. It was great to get ideas on what to do, but the instructor gave few specifics and left it up to us to "find what works." Well, heck, this is my first baby and I have no idea!!!! I found the class was great for the dads, who finally got really involved in the pregnancy, but any woman who has read some books will know a lot of the childbirth info. It boiled down to about 15 minutes worth of how to breathe, visualize your "happy place," and get massages from your husband. Not that specific I guess.

At this point, I'm so close to delivery that I'm in a quandry. I'm still considering a last-minute Doula or friend who has had her babies delivered by a midwife as a stop-gap. I'm also not sure what to do.