Delivering at Sibley

[Anonymous]

There have been a few post that claim that Sibley is unfriendly to natural childbirth. I am curious as to why people think that. I am with Foxhall and they gave me a sheet on Sibley's L&D procedures and I did not see anything (compared the the hospital where I had my first child without any intervention) on it that made me concerned. I am going by memory, but below are the items that were listed:


1. They require a HepLock - not ideal, but nothing that I had one before I did not have any issues and did not use it.
2. Only have to stay in bed if you have an edidural - since I plan to go without medication I am not really worried about this.
3. Only requires monitoring for 15 minutes in each hour
4. Allow doulas (I understand that they have to be Sibley "approved".
5. Does not allow food and drink during labor - not worry about this because I have no plans on complying with it. For the first delivery my doula and mom were great food sneaker.
6. Can set up the room the way I want - re lighting temperature
7. Can bring in my own music and have who I want in the room - rooms are small so I will not be having a crowd


I understand that the nurses can be pushy, but can't see how they can force you to do what you do not want to do. What am I missing? Should I really look to avoid Sibley (basically switch doctors).

Thanks.

[Anonymous]

I don't think it's that you're missing anything. I think it's that when you have to constantly push back on L&D nurses who may or may not be pressuring or suggesting or offering repeated interventions, it doesn't really create an atmosphere that is friendly to natural birth. I have heard really good things and really bad things. Most of the really good things I've heard have come from women who were open to having whatever interventions their care providers and the nursing staff thought were necessary. Most of the bad things have come from women who went in expecting a comforting and natural and frankly non-medicalized birth experience.

I'd say that if you are very invested in a natural experience, looking somewhere other than Sibley would be a good idea. And that looking somewhere that's not an OB practice would be a good idea. But if you're not really invested, it's probably as good as any other hospital.

[Anonymous]

Oops, this is the PP. Also meant to say that I think it's about having reasonable expectations. OBs are doctors and trained surgeons. They are more likely as a group of care providers to gravitate towards a medical or surgical solution rather than one based on meditation or massage, if for no other reason than that they are not trained as rigorously in those things as would be a midwife.

[Anonymous]

Anonymous wrote:I don't think it's that you're missing anything. I think it's that when you have to constantly push back on L&D nurses who may or may not be pressuring or suggesting or offering repeated interventions, it doesn't really create an atmosphere that is friendly to natural birth. I have heard really good things and really bad things. Most of the really good things I've heard have come from women who were open to having whatever interventions their care providers and the nursing staff thought were necessary. Most of the bad things have come from women who went in expecting a comforting and natural and frankly non-medicalized birth experience.

I'd say that if you are very invested in a natural experience, looking somewhere other than Sibley would be a good idea. And that looking somewhere that's not an OB practice would be a good idea. But if you're not really invested, it's probably as good as any other hospital.

Op here, I am very invested in natural childbirth. If I were a first time mom I would likely be more worried about the potential pressures from the staff but having been through it before and successfully pushed back to both doctors and nurses I am not that worried.

[Anonymous]

I delivered at Sibley with no epidural and never felt like I was being pressured into anything. The nurses were very supportive!

[Anonymous]

You might be fine... I personally bailed on Foxhall/Sibley since the more I talked to the Foxhall doctors the more I realized I would have to be going through labor and battling things out along the way, and I didn't want to have to deal with that (this is my first time so I don't know what I am in for, I realize). Talk to Foxhall about their procedures as well. They will want to induce you with Pitocin at 41 weeks if you are not in labor yet, and after they have a time limit for "progress" to occur before they will start wanting to intervene more (this is at least what I was told by a doctor). All that might not be applicable depending on when you go into labor and how fast things go but be sure to ask about these situations if you haven't already.

I think it's certainly possible to have a natural birth there, but it's probably not as easy as it would be elsewhere and you have to hope the cards line up for things to go smoothly. You probably have a better chance if you've gone through labor before and can push back with confidence. I wasn't sure I'd be able to do that, myself!

[Anonymous]

I am a former L&D nurse and pregnant with my third so this post is somewhat entertaining to me. The L&D nurses are not going to force you to have an epidural but many woman come in saying they want a non-medicated birth experience and once the first contraction hits- they want medication. Then, they complain later that they were not encouraged more by the staff. I would say 4 out of 5 women who want 'natural, no pain medication, intervention free' births change their mind very quickly and then blame the staff.

[Anonymous]

I delivered at Sibley, and felt absolutely no pressure to get an epidural. Why would my nurse have cared if I wanted one or not? Actually, I felt like because I had started off saying that I wanted to "try" going natural, she asked me numerous times if I really wanted one when I decided that I did..and by that time, the pain was really bad and I REALLY wanted one.

Another thing -- and this might be true of all hospitals/practices, not just Sibley/Foxhall -- but I was induced with pitocin (for low amniotic fluid) and once one pitocin, you are required to have constant fetal monitoring. That made it impossible to move around and try different laboring positions, which is why I eventually just decided to go for the epi.

[Anonymous]

I had a natural delivery at Sibley 3 yrs ago, so things might have changed. I found that they were supportive, for the most part. For example, they complied with my request not to offer an epidural and worked with me to hold the monitor for the required 15 minutes so that I didn't have to be in bed (although I recently requested my chart, and it's filled with complaints about that). When it came time to push, however, the IV went on and I was on my back faster than anything. At that point, I was too tired to complain; it's only in retrospect that I'm annoyed that my request to push in different positions wasn't respected. Oh, and they insisted on more internals than I would have liked.

[Anonymous]

i agree that no one can force a mother to get an epidural but i think it is ingenuine to suggest that nurses have no responsibility in whether mothers get an epidural or not. i have attended a lot of births as a doula, and have seen some nurses who are super supportive of mothers who want a natural birth, and some who keep asking every fifteen minutes "Are you ready for your epidural yet?" When a woman is asked repeatedly if she is "ready yet" for her epidural, even if she stated upfront that she didn't want to be asked, she ends up feeling like she isn't coping well, or that the epidural is inevitable. I have had clients feel really frustrated about this after the fact. i have had a couple of nurses admit (after moms decided to get epidurals) that their job is much easier when the moms get an epidural, because the nurses are so busy and don't have time to do labor support.

so while i agree that nurses of course cannot force women to get epidurals, i do think that some nurses are more likely than others to influence things in that direction.

also i think that in general, hospital policies make it hard for women to cope with the pain of labor -- having to be in bed, having to be monitored, not being able to eat and drink, constantly being interrupted to answer questions, sign forms, etc. -- these things make it hard to concentrate on labor and cope with the pain, and as a result a lot of women request epidurals who didn't initially want one.

so yes i agree we are all individually responsible for our choices, but i also think it's important to look at the big picture of how nurses, doctors, midwives, and hospitals function, because i believe they do have an effect on women's choices and experiences.

my own feeling is that for someone who wants a natural birth, it is risky to go into an environment that has a reputation for being unfriendly to natural birth. you might get a fabulous nurse, but you also might not. i'd at least plan to go in with a doula, or with a provider who i felt confident would support my wishes, and not just "allow" a natural birth, but encourage it.

Anonymous wrote:I am a former L&D nurse and pregnant with my third so this post is somewhat entertaining to me. The L&D nurses are not going to force you to have an epidural but many woman come in saying they want a non-medicated birth experience and once the first contraction hits- they want medication. Then, they complain later that they were not encouraged more by the staff. I would say 4 out of 5 women who want 'natural, no pain medication, intervention free' births change their mind very quickly and then blame the staff.

[Anonymous]

Anonymous wrote:i agree that no one can force a mother to get an epidural but i think it is ingenuine to suggest that nurses have no responsibility in whether mothers get an epidural or not. i have attended a lot of births as a doula, and have seen some nurses who are super supportive of mothers who want a natural birth, and some who keep asking every fifteen minutes "Are you ready for your epidural yet?" When a woman is asked repeatedly if she is "ready yet" for her epidural, even if she stated upfront that she didn't want to be asked, she ends up feeling like she isn't coping well, or that the epidural is inevitable. I have had clients feel really frustrated about this after the fact. i have had a couple of nurses admit (after moms decided to get epidurals) that their job is much easier when the moms get an epidural, because the nurses are so busy and don't have time to do labor support.

so while i agree that nurses of course cannot force women to get epidurals, i do think that some nurses are more likely than others to influence things in that direction.

also i think that in general, hospital policies make it hard for women to cope with the pain of labor -- having to be in bed, having to be monitored, not being able to eat and drink, constantly being interrupted to answer questions, sign forms, etc. -- these things make it hard to concentrate on labor and cope with the pain, and as a result a lot of women request epidurals who didn't initially want one.

so yes i agree we are all individually responsible for our choices, but i also think it's important to look at the big picture of how nurses, doctors, midwives, and hospitals function, because i believe they do have an effect on women's choices and experiences.

my own feeling is that for someone who wants a natural birth, it is risky to go into an environment that has a reputation for being unfriendly to natural birth. you might get a fabulous nurse, but you also might not. i'd at least plan to go in with a doula, or with a provider who i felt confident would support my wishes, and not just "allow" a natural birth, but encourage it.

EXACTLY. THE PERFECT ANSWER.

[Anonymous]

I think the L&D nurses at Sibley are great. I had a great experience 2 years ago and am not worried about my delivery this summer. As for an epidural, yes, I got one. However, I did feel that the nurse was actually trying to talk me into waiting longer than I wanted to. She was nice and not pushy, but I felt like she wanted me to labor on my own longer. So, as for natural, I'm sure they are all for it!

[Anonymous]

I really loved my L&D nurses at Sibley, but I completely agree with 21:20 on this one. If you are 100% committed to having a natural birth, you should look into alternatives. Sibley is a great hospital for many reasons, but it is not going to provide the level of support for natural birthing that a birth center or another hospital would provide. I have always wanted epidurals. So for me, Sibley is a good fit. This isn't meant to bash the L&D nurses there b/c I truly believe they are exceptional. But the problem is that with Sibley, there are hospital policies in place that make it more difficult to labor naturally. And for a woman who isn't 100% committed to a non-medicated birth, chances are she will get an epidural b/c that is just what happens at Sibley. Of course, I do know women who have delivered at Sibley without one, but mostly b/c they had VERY short labors and waited quite a while to get to the hospital.

IMO, if you want a natural birth and want to deliver at Sibley, labor as long a possible at home. Otherwise, you may run into problems.

[Anonymous]

I cannot offer any advice about natural birth at Sibley b/c I had a planned C-section. That being said, I was surprised at how fast they moved me from the L&D room where they put me before and immediately after the C to my post-partum room. I had general anesthesia and as soon as I woke up, they wanted me to go to my post-partum room. I was barely conscious when they brought me to the post-partum room. I get the sense that Sibley is a very busy hospital for L&D and they are trying to get women in and out of the L&D rooms as fast as possible. I am sure some people would disagree, but anyway, that was my experience.

[Anonymous]

Anonymous wrote:I really loved my L&D nurses at Sibley, but I completely agree with 21:20 on this one. If you are 100% committed to having a natural birth, you should look into alternatives. Sibley is a great hospital for many reasons, but it is not going to provide the level of support for natural birthing that a birth center or another hospital would provide. I have always wanted epidurals. So for me, Sibley is a good fit. This isn't meant to bash the L&D nurses there b/c I truly believe they are exceptional. But the problem is that with Sibley, there are hospital policies in place that make it more difficult to labor naturally. And for a woman who isn't 100% committed to a non-medicated birth, chances are she will get an epidural b/c that is just what happens at Sibley. Of course, I do know women who have delivered at Sibley without one, but mostly b/c they had VERY short labors and waited quite a while to get to the hospital.

IMO, if you want a natural birth and want to deliver at Sibley, labor as long a possible at home. Otherwise, you may run into problems.

OP again, I plan to do this as well. Follow-up question, if not Sibley then where. Is there a "natural birth friendly" hospital. A birth center will not work for me for two reasons a) my husband is against it and I do not think it is a fight worth having and b) I want to have a medical procedure done as soon as possible after delivery.