Looking into a natural birth...
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Anonymous
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OP--I was in a similar situation to you. I loved my OB, who practices at Sibley. But I called Sibley and asked how often they had unmedicated births there, and they basically told me "not often." I did not want to be in a place where they had little experience with the kind of situation I wanted (assuming all went well and no complications came up)....because I figured my OB would not be there the whole time and I would really be interacting with the hospital people. A doula is all well and good, but a doula cannot fight back against the hospital protocols on your behalf...only the patient can do that, and I did not want to be having discussions with strangers about electronic fetal monitoring when I was in active labor.
At about five months I switched. It was hard to do because I loved my OB but I explained to her and she understood. I ended up going with a home-based certified nurse midwife practice. I had a natural birth at home. My husband was skeptical, but once we looked at the research showing the safety of midwife-assisted birth for low risk pregnancies, he became comfortable even with home birth. In DC, I bet if you look around you can get a midwife assisted birth in a hospital, even this far into your pregnancy. You could try calling the midwives at the DC birth Center and tell them you want to birth with them at Washington Hospital Center, for example. If you have doubts about your current plan, I think you should not just assume that it is "too late" to switch. People switch all the time for all kinds of reasons. After my nonmedicated birth, I came away feeling like it was doable but not easy. I really was glad I had myself in a situation where everyone around me was supporting my efforts to birth without unnecessary intervention. I was also glad I took a Bradley class, which prepared me and DH for what would happen in the various stages of labor. At the very least, if you do decide to stay with your current plan, a doula could help you put off going to the hospital for as long as possible, so you can get as advanced as possible in labor before going to the hospital. Good luck to you! |
Anonymous
I don't necessary agree that it doesn't matter who oversees your care or who your OB is. Even though it's true that the OB isn't in the room with you during a large portion of your labor/birth, they do have a lot of power and influence when it comes to protocols and how things unfold. They are still in communication with the nurses (in the hallways, by phone, etc.) even if you don't see them. As a doula I've seen similar circumstances handled completely differently in an OB practice versus a midwifery practice, and it doesn't necessarily matter if the OB or midwife is actually in the room -- they have procedures and protocols that the nurses carry out, or that impact the course of labor, even if they're not standing right in front of you.
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Anonymous
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My advice:
1. Read Pushed by Jennifer Block immediately. It really opened my eyes to the correlation between induction and intervention. The book pushes evidence that if the baby isn't ready to come, induction is a fast way to get a c section. Also 40 weeks in the mean delivery time with births ranging from 38-42 weeks. All this crap about the baby becoming too big in the womb really needs to be examined. 2. Also on netflix is "more business of being born" - wouldn't hurt to watch it. 3. if you decide to stay at sibley with your OB, I would doula up ASAP. and plan to labor at home for awhile with her. This way you can do all the walking around, showering and eating you want. 4. Wisdom has some great diet and herbal reccomendations that might be beneficial to your labor. They are available on their website: http://www.gwdocs.com/midwifery-services/nutritional-guidelines |
Anonymous
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I delivered two children at Sibley, the first was medicated, the second was not. Both were great experiences and the nurses and doctors could not have been better and more supportive.
FWIW (which is nothing, I'm sure!) if we got for #3 I'm medicating the second we get through the hospital doors! Good luck! |
Anonymous
| Just to add my two cents into the mix... My 1st was medicated (not an epidural, but with narcotics) and 2nd was an unmedicated home birth. If we ever decided to have a 3rd (and there were no complicating risk factors), I would love to have another home birth. The amazing care and attention I received from my midwife and birth assistant was unparalleled. The sense of joy and peace that I experienced (I think my husband too) being in the comfort of our own home was incredible. I had an intense rush of emotions and a natural high after birthing without medications and I would recommend for everyone who might be interested. It's hard work, but definitely possible if you're committed to it. Best of luck to you. |
Anonymous
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OP, I have also heard Sibley has a very high c-section rate. I would most certainly switch if I were you -- that, combined with the long drive would be enough (BELIEVE me, you don't want to be stuck in the car for a long time while you're having contractions! I hit transition in the car and I thought I was going to die).
1. Definitely get a doula, even if you switch to a midwife practice. Totally worth it -- the doula will make you comfortable (as possible!) and will let your husband relax a little if your labor is long (and FTMs usually have long labors). 2. Be prepared for it to hurt and to take a long time. My labor was about 30 hours and the contractions were really close together, plus it started at night (so I was exhausted). With good support (i.e., a doula) you can still do an unmedicated birth even in less-than-ideal situations like this 
3. I really liked The Thinking Woman's Guide to a Better Birth by Henci Goer. Lots of evidence- and science-based information on labor and delivery. I'm a real science girl, so it was helpful for me to see the reasons interventions often cascade out of control and to understand the biology behind a normal, unmedicated vaginal delivery. It helped me stay strong and not cave into gateway interventions (epidural) during aforementioned long and painful labor! |
OBnurse
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To build on the great advice from other members, when you actually 'go in' is the greatest predictor of success in achieving natural childbirth in a hospital environment. A good doula will come and help you labor at home, and can hopefully offer cervical assessment for evaluating your progress (although this courtesy is not a practice standard). She or He will know what things you need to go in for sooner, such as meconium stained amniotic fluid, treatment of GBS if your water has broken, bleeding, or if the baby isn't active. The second you get to a hospital, they put your progress on a clock. This is the ever dreaded, 'curve.' Natural labor very rarely follows the 'curve', and is eternally misdiagnosed as being dysfunctional just because it isn't efficient. If you want a natural child birth, your best success will be facilitated by laboring safely at home and presenting to the hospital at, like, 8cm. |
Anonymous
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Another vote for the OB mattering. It helps to have nurses who are used to seeing natural birth, like at VHC, and you definitely want a doula, but when it gets down to it if your OB says it is time for a c-section or that you really need pitocin to speed things along because she is worried about the baby, are you going to say no? No.
Once a care provider raises the issue of the baby's safety you'll do anything they suggest. So you need to be sure going in that you agree with your OB's view of how hard to resist intervention. I FULLY trust my midwife and the OBs at AWC. If they ever told me I needed a c-section I would first ask if we can try anything else first and if they said "no," I would be confident then and later that a c-section was the best thing. The value of trusting them is high to me. |
Anonymous
| Nothing against Sibley, but I'd think about your drive there from Woodbridge if it happens during rush hour, or if your labor progresses faster than expected. Not pleasant. |
Anonymous
| (I'm 13:42) Also wanted to say that I've had two babies (neither at Sibley). The first was vaginal with an epidural, and the second a long, long unmedicated labor followed by a c-section. I was bummed to end up having the c-section, but the recovery really wasn't too bad. I didn't feel too much worse than I did after the first time. Obviously it's major abdominal surgery and you want to avoid it if possible, but it's not the end of the world either. Don't beat yourself up if it happens. |
Anonymous
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birth plan:
Go to hospital, listen to doctor, have baby |
Anonymous
baby should not be in longer than 39 weeks. that's science. |
Anonymous
"Dr." Amy sighting! |
Anonymous
Life plan: Let each woman birth as she wishes. |
Anonymous
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Just delivered my second unmedicated baby 2 weeks ago at VHC. The trick for me (and this worked for both babies) is to labor at home for as long as possible before going to the hospital. By the time I got to VHC, I was 9+ centimeters dilated both times and ready to go - so no time for epidurals or any intervention! My doula was indispensable, in helping me cope through contractions at home, and deciding when it was time to go in. I was GBS+, so since I never got the full dose of antibiotics before they came out, they just had to keep each of my girls at the hospital for at least 48 hours to make sure they were ok.
I have had at least 3 friends who have had problems with epiduralsb (during, and long after), so the big scary needle was definitely not for me. I wouldn't suggest waiting too long to go to a hospital unless you know that you are low-risk. |