When a woman is deciding where to have her child, she has many options. Birthing centers are wonderful facilities for moms with low-risk pregnancies who want a calm environment. Home births are also a popular option.
However, most moms still choose hospital births due to the fact that they want to be at a location where if anything goes wrong, help is right there.
Many hospitals are supportive of birth plans and want mom to have the experience she dreams of for her and her child. Nurses and doctors work hard to ensure everyone is safe and comfortable, and many moms report being satisfied with their hospital births.
Although there are some who feel limited by hospital policies and rules.
It’s true that hospitals have a say in how mom births. While a hospital can’t force a woman to do anything, they can refuse to treat her if she doesn’t agree to their terms.
Most of the time the rules are clear and there for a reason, but other times they make birthing more difficult and impede mom’s ability to move forth in labor the way she’d like.
While hospitals are still a great choice for labor and delivery, mom should know going in that hospitals don’t always allow mom to birth on her own terms. Every hospital is different, with some being much more cooperative than others.
It’s important for mom to find out what kind of hospital she is birthing at and if they prohibit the following during labor and delivery.
15 Labor In Different Positions
We’ve all watched the stereotypical labor scene play out in a movie or on TV. Mom is on her back in the bed with her feet in stirrups, gravity working completing against her, while a doctor waits for the baby at the foot of the bed.
While it’s true many women successfully deliver this way, it’s not the only birthing position. Unfortunately, it’s the only one many hospitals give mom the option of trying.
The reasons for this are layered. If a woman chooses an epidural, she pretty much confines herself to a delivery in the bed, and that’s okay. There’s no way to squat or sit up if mom can’t feel her legs.
However, for women who want to avoid pain meds, there are many other birthing positions that can help the baby move down the birth canal, so it’s difficult to understand why some hospitals don’t let mom use them.
Certain doctors will fight for a mom’s right to birth the way she chooses, but if hospital policy dictates that mom has to be hooked to an IV and a fetal heart rate monitor at all times, it will be difficult for mom to be anywhere but tethered to her hospital bed for delivery.
14 Water Birth
The advantages of water birth are many: soothing warmth of water, more energy in the later stages of pregnancy, and easier movement are just a few. The problem is if mom wants to deliver in the water, she needs to find a way to have a home birth or deliver at a birthing center.
Very few hospitals allow women to deliver this way.
The reasons are sketchy. Though it’s true that not many studies have been conducted about water birth, those that have show the same risks as a woman delivering outside of the water. Still, doctors are hesitant because of the remote possibilities of something going wrong.
However, the tide could turn as researchers are finding many of the risks associated with water births are due to mom and baby being at home in a situation where they can’t receive immediate care.
Some feel that as opposed to the water being a risk, the true risk comes from not having emergency care immediately available, whether it’s a water birth or not.
New thinking on this topic will hopefully change minds, but for now if mom hopes to birth in water, she probably doesn’t need to deliver at a hospital.
13 Going Without Monitoring
One of the first ways mom will be greeted at the hospital is by an IV. Intravenous therapy is used to put fluids directly in mom’s veins, and it’s standard procedure for doctors to make mom have one even if she is coming in as a low-risk delivery.
The reason is that if there is an emergency, the IV will already be in ready to administer medication.
A fetal heart rate monitor is also placed around mom to monitor the baby’s heart at all times during labor. This lets the doctor know if the baby is stressed.
The problem with being forced to wear these devices is that mom can’t move freely during labor, and in the case of constant fetal heart rate monitoring, the monitoring itself does not seem to increase positive results. In fact, it can actually make mom more likely to receive a C-section.
Studies showed that women who were only monitored intermittently throughout labor had babies who were in just as good of shape as women who were monitored constantly. These women also had a much less likely chance of a C-section or a delivery using forceps or a vacuum.
12 Eat During Labor
While there is now, thankfully, a turn towards letting women eat during labor, many doctors and hospitals had a policy against it, and some still do. It’s important for mom to ask the doctor and to check with the hospital about if she can eat, because trying to labor with an empty stomach does not make the experience easier.
The old school of thought was that food in the digestive system could cause a woman to aspirate. If mom needs emergency anesthesia, doctors don’t want her coughing up and choking on food. However, mom probably won’t have to worry about this rare situation. Even if she does, it’s not likely that she will have issues with aspiration.
Moms are now encouraged to eat small snacks throughout labor to keep their energy up. Eating has even been shown to shorten labor, so if a hospital refuses to let mom eat, there is plenty of evidence to prove that the hospital is in the wrong.
A vaginal birth after C-section(VBAC) is usually a safe method of birth for the mom who doesn’t want to undergo another C-section. The problem is many hospitals have a VBAC ban that prohibits women from even attempting this kind of labor.
Oddly, safety isn’t the reason. Moms who are good candidates and decide to VBAC are actually at less risk for complications than those who have repeat C-sections.
The problem is that it is now required that hospitals be able to provide immediate C-sections, meaning they have to have a surgical staff on hand 24/7 if someone is attempting to VBAC. Though there have been no proven benefits to this requirement, it still stands in the United States.
Many birthing centers give mom the option to VBAC, but many do not. Because of this, mom will have to do her research and choose wisely before deciding where to try to deliver by VBAC.
10 Deliver A Breech Baby Naturally
When doctors say a baby is breech, they mean that the baby is not in the head down position that is preferred for labor. Babies may be frank breech, complete breech, or incomplete breech, but if they are breech at all, the bottom or the feet are presenting first.
While this is not ideal and everything should be done before labor to help the baby turn to the head down position, it is possible to deliver a child breech if the circumstances are right. In fact, babies can turn during labor and still head right out of the birth canal, giving the doctor no choice but to deliver breech.
It also happens in the case of twins when one is head down and the other is breech. Breech deliveries are possible.
The problem is many doctors and hospitals don’t want to take on the extra risk of letting a woman labor with a breech baby. Though it is possible to simply watch how the situation progresses and move to a C-section if necessary, many hospitals require a mom to deliver by C-section before labor even starts if the baby is breech.
9 Labor As Long As Needed
Luckily, depending on where mom delivers and who her doctor is, this might be less of a problem. However, putting mom against the clock is still a common practice in hospitals, even if she has a low-risk pregnancy.
The practice of not allowing women to labor or push for longer than a given amount of time is often cited as the main reason for the increase in C-sections.
The problem is many doctors still follow the guidelines that say a mother should be forced into a C-section after a certain amount of time, even if there’s no reason. The mere fact that a woman is laboring longer than expected is still cause in many hospitals for operative intervention.
The American College of Obstetricians is hoping to change this with guidelines that aim to give mom more time to deliver her child vaginally. However, not every hospital is on board, and for moms who are attempting to VBAC, there will still likely be strict guidelines as to how long labor is allowed to go on.
8 Delaying Cord Clamping
Though there is information available that proves letting the blood from the umbilical cord pulse instead of immediately clamping the cord is beneficial, most doctors and hospitals still clamp and cut the cord as soon as the baby emerges from the womb.
Whether it is habit or hospitals just aren’t as up to date as they should be, mom will have to request that the cord be allowed to pulse for her child to receive benefits from this procedure.
When the cord is left attached for two to three minutes after birth, the benefits to baby can be profound. Twenty to forty more milliliters of blood go from the placenta to the baby during this time, and that provides them with much needed iron. It also increases their hemoglobin and puts them at less risk of anemia.
Not all hospitals will honor mom’s request to keep her baby attached to the placenta, so she needs to talk to her doctor beforehand if she wants to do this. Hopefully the hospitals will catch up with the available research and allowing the cord to pulse will become common practice.
7 Use A Birthing Ball
Birthing balls allow women to sit and maneuver the body to find a comfortable position to labor in. Many women also enjoy draping their bodies over birthing balls so their husband or doula can massage their back.
Birthing balls have also been proven to keep blood flow to the uterus and the baby strong and relieve pressure on mom’s back. They are cheap, easy to pack, and they may help the baby make his way into the birth canal in the right position.
Why would any hospital not be on board with this? It mainly goes back to the hospital’s desire to keep mom tethered to the bed. With an IV and a fetal heart rate monitor holding mom down, it’s not easy to squat on a birthing ball.
It may be possible, but having to work around so many cords and wires takes a bit of the relaxation out of the experience, and some hospitals don’t allow the use of them at all.
6 Allow A Midwife To Assist
Certified midwives provide exceptional care for many women across the world, and midwifery has been used for centuries. Unfortunately, that doesn’t guarantee a midwife will be able to assist mom in the hospital.
Most midwives work in birthing centers or with women who want a home birth. For a woman who wants the benefits of a midwife combined with a hospital birth, she will need to ask a ton of questions and understand that she may be denied the right to a midwife in a hospital.
Most midwives across the United States have to have an agreement with a physician to be able to assist in a hospital, which puts the midwife in direct competition with the person who is allowing them to practice.
Women who need to be taken to a hospital from a birthing center or homebirth due to a situation that needs to be handled in a medical setting may find their midwives unable to come along. They will have to get used to a doctor they’ve never met while in the middle of labor.
5 Receive An Epidural Too Early
There are women who know they want natural childbirth without drugs from the very first moment they get pregnant. There are others who want to know the exact second an epidural can be administered.
Neither mom is wrong in her choice, but the mom who chooses the epidural needs to know that hospital policy guarantees she won’t escape all labor pain.
Most hospitals prefer to avoid giving mom an epidural until she is around four or five centimeters dilated. While it is possible to receive other pain relief through an IV, doctors and hospitals fear an epidural too early will slow down contractions and stall mom’s labor.
If mom decides on pain meds through her IV, she needs to know they can make her tired and she likely won’t be able to leave her bed to change positions.
This is one hospital decision that makes sense. Though it’s hard to feel the pain of labor, reducing the chances of slowing it down and therefore causing future interventions is a good idea.
4 Allowing Her Supporter To Be With Her During Epidural/Spinal
Receiving a spinal or epidural to block pain can be a relief, but it’s also a scary experience. The thought of having a large needle placed in the spine and then having a tube left behind to pump in fluid can make the most stoic person nauseous. Most women want someone they trust by their side when it’s time for this procedure.
Unfortunately, that’s not likely to happen. Many hospitals ban dad from the room while the spinal or epidural is being given. The reason basically comes down to liability. Hospitals don’t want to take the chance that mom’s partner is going to pass out and sustain an injury when they see a huge needle inserted into mom’s back.
While it’s hard to go through this without dad around, this policy is understandable. Mom should ask her doctor or a nurse to serve as her support team while she goes through this, and she can also ask them to grab her partner as soon as possible to join her when it’s over.
3 Let Dad Catch The Baby
There are plenty of beautiful birth photos that show dad lovingly catching the baby as mom delivers their child. Most of these take place during home births or in birthing centers because dad catching the baby is a remote possibility in a hospital.
While it’s possible for a doctor to allow dad to be this involved in the birthing process, it’s unlikely because hospitals are businesses that want to cut down on issues that could hold them liable for damage. If dad drops a baby or the doctor is concerned about possible germs if dad helps, then he won’t be given this chance.
Since dad being involved in delivering the baby is possible at birthing centers and during home births, it is definitely realistic for hospitals to allow the practice. They just generally don’t because most doctors like control over the process, and hospitals want that as well.
2 Labor Without Checking In, Literally
While it can be nice for mom to know how many centimeters she’s dilated, it can also be discouraging if she feels like she has been laboring for hours and then finds she’s only progressed one centimeter.
A woman's cervix isn't programmed to dilate on a schedule, so one mom may progress steadily while another doesn’t progress for hours and then is suddenly at nine centimeters.
That’s a big reason that vaginal exams during labor can hinder as much as they help. Plus, these exams increase the risk of infection and the chance that a doctor is going to start using interventions to speed up labor.
Mom has the right to say no to excessive vaginal exams, but she needs to be verbal about it or discuss it with her doctor beforehand. Common practice is to check a woman often, even if it’s not necessary, so mom will need to fight for her right to be allowed to labor without worrying about someone sneaking under her gown to check her progress.
1 Deliver In The Dark
While this one should be an easy fix, mom may want to ask her doctor if the hospital will let her keep the lights low during labor.
She also needs to request no huge spotlight be aimed at her lady bits while she is pushing. The doctor should be able to check dilation and see a huge baby head popping out without a gigantic spotlight aimed at mom’s nether regions.
Why does this matter? Melatonin receptors in the uterus are helpful during labor because of the hormone oxytocin. Oxytocin produces contractions, so anything that increases melatonin is a win because that will help with oxytocin. Low light is ideal for melatonin, not bright light.
This is a small thing, but unless mom asks, the hospital and doctor will probably be in the habit of flipping on the big headlight before checking mom, and that could interrupt the labor groove.