Thursday, September 27, 2007

"A guide to your labor and delivery" and other thoughts on homebirth

In the mail yesterday came a "guide to your labor & delivery experience" from the hospital where the back-up doctor we saw delivers his babies. I read through it with piqued curiosity. As you all may know, we delivered at a hospital last time but it was on the midwife unit. We had 1 room for labor, delivery, recovery, and postpartum (LDRP); although, we ended up delivering in another room because that was where the birthing pool had already been set up and we were moved to the OB unit the next day. So I guess we didn't really get a full LDRP experience anyway.

Here are a few things that this hospital overviewed:

  • 8 bed maternity unit, 3 LDRP rooms.
  • Additional private rooms with semi-private baths are available.
  • If a c-section takes place under normal circumstances, the support person can be present. If it takes place under emergency situations, they cannot: they can see the baby as soon as it is taken to the nursery.
  • The child can stay in the room with the mother as much as she wants, but there is a nursery with highly-skilled nurses on stand-by so she can rest and recuperate before going home.
  • Hospital policy allows that video footage can be taken before and after delivery, but not during delivery.
  • Permission must be obtained before medical staff can appear in any pictures.
  • Nurses and lactation consultants are on hand to help with breast-feeding.
  • Physicians will determine how the mother and infant are doing medically before a decision is made concerning discharge.
  • Visitors must be healthy and must wash hands before handling the baby. There will be no visitors after 8:30 pm.
  • Breakfast: 8:00 am - Lunch: 12:00 pm - Dinner: 6:00 pm - Lunch & Bedtime snacks are also offered.
  • No smoking on any hospital property, inside or out. To assist smokers, free nicotine gum and lozenges are available to patients, families, and visitors at the Information Desk.

I found this to be fascinating. It also spurred memories of visiting my mom in the hospital after delivery, in rooms where curtains were drawn and other people where on the other side of the fabric [we were probably visiting you, Erik]. I had forgotten about that. How terribly uncomfortable! Even as a fairly open person, I think that would make me feel uneasy. I can't imagine the torture it would be for someone who leans towards being extremely private. Like my husband.

I didn't post this to say, "Look at how terrible the hospitals are!", but I did I post it to contemplate how much procedure is included in a hospital birthing process and how normalized hospital births have become within our society. It is just expected: You give birth in the hospital. That's how it is done. [I can't even tell you how many raised eyebrows and incredulous looks I've had over the past 8-9 months.] I also posted on this out of sheer interest and for what I consider to be a loss of privacy.

Several of the stated rules are there to protect the hospital's interests, as with the policies on video footage, staff pictures, and discharge. I suppose the emergency c-section rule could fall within that category as well, although I'm not 100% sure of the reasons behind this policy. Trauma? Keeping the space clear? Safety?

Some of the rules, like healthy visitors, hand-washing, and no smoking are no-brainers. Most parents probably adhere to these no matter where they give birth. I thought it was pretty interesting that there is no smoking on any hospital property. I assume that includes employees - I wonder where they go to smoke? The guide specifically states that smoking in a car in the hospital parking lot is included in the restrictions. No sidewalks, parking lots, or even cars in parking lots. Fascinating!

The 8 bed maternity unit with 3 LDRP rooms made me wonder: Are there 2-3 beds to each room, with a shared bathroom for the remaining 5 beds? I walked around completely butt-naked for most of my labor and at least 1 day after delivery. In fact, the day after delivery, I can remember a hospital worker knocking on the door, saying, "Food service!" I was in the bathroom whose open door faced the room door, naked as a jay, preparing for yet another sitz bath and said, "Come on in" like being naked was the most normal thing in the world. She blanched and looked like she was going to back out, so I said, "No really, come on it -- I don't care." So she did, the poor thing; I'm sure she was traumatized. Anything even resembling modesty left me for a 2-3 day window. [This may surprise my close friends, who have never seen me naked even once. They've probably seen my boobs within the last couple of years though.]

Segway to thoughts on birthing:

Yesterday was 36 weeks for me. Starbeans was born at 38.5 weeks. As my time draws closer, I am contemplating more of what our labor and delivery will be like at home. I am really looking forward to it. Not only to GET THIS BABY OUTTA ME (yes, I've reached that point: I remember now, how terrible the last month is - and it is only going to get worse), but also to experience giving birth in the comfort and privacy of my own home. I wonder if it will go faster, or at least seem quicker, because I'm at ease in my own cozy surroundings. I know for a fact that I will be happier. Squeeze will be too: I can't wait to hear his reflections on it after the fact. He has been slightly adverse to the idea of a homebirth, mostly because we probably won't be able to get it covered by our insurance. But consider this: our midwife charges 1,500 plus cost of gas for all prenatal visits; we also ordered 37 dollar birth kit that she set up from an online homebirthing supply company. I met with a midwife in Minneapolis who charged 3,000. Our midwife is from SD, which probably explains the difference [cost of living]. Our last birth on the midwife unit at HCMC in Minneapolis cost 14,000. I'm not kidding. That was the grand total. After insurance, we paid 800 of that (but that doesn't include the co-pays during prenatal care). To me, that 700 dollars is nothing. The trade-off is worth every cent. And can you imagine how massive the ease of financial burden would be on either the individual or the state, for those who do not have insurance?


We have also decided that depending on the onset and duration of labor, Starbeans will go to my MIL & FIL's house. The midwife said that 2 years old is the hardest age to have around for the laboring part, particularly. They are so demanding [yes!] and don't have any kind of a grasp of what is happening; she has had women whose labors have slowed because of this. It makes sense to me. I'm not sure that he would be able to let go of me, so to speak, for any length of time: and that definitely does not lend itself to focusing on moving labor along. We'll have to send the potty chair along with them!

I will probably be posting more on my feelings about our impending homebirth in the future. I will definitely be posting on my thoughts on it afterwards. It should be interesting! I can honestly say that I can't wait. Later, babes.


Jenni said...

I'm so excited for you, and can't wait to hear about your homebirth experience. Honestly, it makes me want to have another baby, isn't God funny :) We have this amazing ability to forget all the hard stuff and only remember the wonderful glorious afterglow of holding that precious baby. Bless you in these days of preparation!

You know that if you start getting weepy about Starbeans not being the only child anymore, your new one is very close :)

purple_kangaroo said...

Sounds like a good plan.

ms said...

wow. i do wish we had talked more about homebirthing. i'd love to know what your list of supplies includes. we have our list too and have been looking over it and getting excited about planning!! i can hardly believe you are almost there! i still feel like i have so much farther to go.
it is a strange thing to recall the hospital experience and how different this pregnancy has been, simply because we are planning a homebirth. yippe!