Birth in a Hospital

Hospitals are a good place to give birth if you have a need for medical treatment that an independent midwife can't give you (remember that midwives are the normal birth specialists). Hospital births can be attended by GPs, obstetricians, nurses and/or a team of midwives (depending on which hospital you go to). Due to rosters, you may receive care from different members of staff at different times depending on how long you are in labour for. If you want continuity of care the but require medical assistance during labour a doula or an independent midwife is a great option.

If you want a natural birth a hospital is not the best option, only a small minority of women (5%) who birth in hospitals manage to have normal intervention free births. Birthing in a hospital increases your risk of caeasarean by 50%. You will need to be highly motivated for a natural birth, and you will need strong and constant support throughout the labour. If you are fortunate enough to have an obstetrician who is happy for you to have a natural birth, be aware that your obstetrician is not with you for most of the labour, hospital midwives (as opposed to independent midwives) and nurses are. And if you are lucky enough to have midwives and nurses who are happy for you to have an intervention free birth when you arrive there is no gauruntee that when the shift changeover happens the next group of hospital staff will be as supportive.

Research shows that the most successful way of achieving a normal birth in a birthing institution such as a birth centre or hospital is to have continuity of care. You may feel highly motivated for a natural birth at the start of labour, but as time passes and you become tired and possibly face crises of confidence that are completely normal for birthing women in our culture, your resolve may weaken and you might end up submitting to something you may later regret. These are the times when a doula or independent midwife are supportive gold!

Before deciding to birth at a hospital:

• Think about the different models of care available to you and whether this suits you. Ask yourself why you require medical attention?

• If you have opted to have an obstetrician as your primary care provider be aware that he or she is foremost a surgeon and may not have seen a completely normal intervention free birth before.

• Find out what are the hospital’s intervention rates are? (drugs for augmentation, drugs for pain relief, episiotomies, caesareans etc.)

• Find out if you are able to have your partner stay with you overnight.

• Find out what is the average length of stay?

• Ask who can be present at the birth (eg. your children? other family members? friends? a doula?)

• Ask if there is a time limit out on how long you can push (second stage)?

• Ask to see some recent customer feedback surveys.

• Look into what kind of assistance you can get from the centre with breastfeeding.

• Find out if the hospital has implemented the baby friendly initiative.
  

• Talk to other women who have given birth there to find out what their experiences were like.

• Write a birth plan that clearly states your preferences, and go through it with the staff to see how they respond.

• Ask yourself what it is you want from a birth centre birth experience that you don't think you will be able to get with a hiring an independent midwife for a homebirth?

• Write a birth plan that clearly your preferences, and go through it with your hospital care providers. But remember that hospitals, like many birth centres, will prioritise their standard procedures and protocols over your plan.

No matter where you decide to give birth the decision always rests with you, and you can change your mind at any time. Just as you are not obligated to stick with the one care provider or model of care you first chose, you are not obligated to stay at the place you initially thought you would like to give birth in.

Doulas
A doula is a trained birth attendant. She is not trained in providing medical care like a midwife or obstetrician, but in providing other forms of support. Her entire focus is you and your comfort. Each doula has a library of information about birth she can share with you. She is able to provide you with information to help you make informed choices, but she cannot make decisions for you, or offer medical advice.

Like a midwife, a doula provides continuity of care, she can help you with breastfeeding, and household maintenance after the birth. During birth she can be as hands on-or off- as you like, she is at your service. Having a doula present has been shown to lower rates of intervention and increase women’s satisfaction with the birth. You can hire a doula as your primary support, or as additional support to your midwife, or your obstetrician. Doulas are great support no matter where you decide to have your baby.

Doula Links:
More about doulas
Doulas and Birth Attendants in Victoria
Australian Doulas
Doula Direcory, Joyous Birth
Find a Doula, Optimum Birth

Helpful links:
Hospital & Birth Centre Birth
Informed Choice in Childbirth
Care in Normal Birth
Victorian Hospitals
Get Me to the Hospital (or Birth Centre) On Time

Related Ilithyia Inspired Pages:
Pregnancy & Birth Websites
Pregnancy Articles
Birth Articles
Birth Stories That Inspire
Doulas: Mortal Ilithyia

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