Navigating The Hospital Machine

I have written a lot about how to get a natural birth in a hospital.  It IS possible and is a wonderful experience for many women.


Well, we all know that sometimes it isn't a wonderful experience.  Plus, for the woman who desires an unmediated birth, the truth is that natural hospital births are a rare occurrence.  While my description of the hospital as a machine may seem harsh, I think it is appropriate.

The hospital is big.  It is efficient.  It is full of trained personnel with jobs to do.  In order for something to be efficient and quick then things are done according to a set plan, with rules and attention paid to accomplishing the various tasks at hand.  The hospital must balance many things: keeping women and babies safe and happy, profit, liability concerns, and the needs, personalities, and training of their staff to name just a few.

It is wonderful to have a well oiled machine to walk into when you get into an accident and need swift, lifesaving care.  But it can feel like a grinding, emotionless beast when we combine it with the hormonal, sensitive, spiritual and physical function of birth.  Add to the mix a group of women who can vary widely in what they consider an "ideal" birth experience and in the way they birth makes it difficult for a well oiled machine to meet the wants of everybody who goes there.  In fact, sometimes women feel like a cog in the works when they desire something as foreign as a natural birth.

Find Your Voice

I am starting to think that the "prep" for the hospital begins with your visits with your doctor or midwife.  There is a routine.  There are things to be weighed and measured.  There are charts to be read and met.  There are standards held for the mother and her baby that sometimes have more to do with efficiency and liability than the individual needs of that birthing family.  

One common part of the prenatal visits, especially in the last month of pregnancy, is the vaginal exam.

You can probably guess what I think about that.  I find this to be far from just a harmless routine.  Not only can it set the seeds of doubt in the heart of a mother, but it helps prepare her to be a willing and obedient participant in the hospital machine.  If you will comply in allowing a stranger to stick their fingers in your lady parts, what WON'T you do?

Maybe you are wondering what on earth I am getting at.  My point is this- if you want to have the courage and strength to stand up to what can be useless routines when you are IN THE HOSPITAL GIVING BIRTH, then it may behoove you to being standing up for yourself during your PRENATAL VISITS.

Kindly but firmly ask questions.  Kindly but firmly assert your needs.  Kindly but firmly refuse procedures that you have decided against.  Kindly listen to your care provider if they have objections.  Then kindly but firmly make a decision.

You may find during your visits that if you do this, your care provider really doesn't enjoy your company any more.  If this is the case, then you may want to mull over what exactly that means for your birth.

Don't just brush it off.  

I believe that if your entire pregnancy has been spent practicing how to be the most compliant, "good" patient on the planet, you may find it quite difficult to assert yourself once you are actually in the depths of strong labor.  Your experience may be very different if you have managed to vocalize and find a care provider who is respectful of you but trained enough to know when other measures are needed.

Speaking up when pregnant, helps prepare you to speak up in labor.

I honestly believe that being able to find your voice, speak for yourself, and feel confident is IMPERATIVE to having a good birth ANYWHERE you choose to birth.

But it doesn't start in labor.  You must do this earlier.  It is intimidating to be in a foreign environment where you are not the expert and where you don't know what everything and everybody does.  It is easy to just fall in line and get what you are handed.

Birth however is not meant to be an assembly line.  We aren't building cars and each woman does this differently and in her own time.  If you feel safe in a hospital then birth there, but that doesn't mean that you should have zero say in your birth.

It is still your BODY and you have autonomy over it.  It is still your BABY and you are responsible for it.  This BIRTH is one that you will remember forever- I can guarantee that.

When we talk about that elusive word empowerment- this is what we mean.  It is something that you realize you have inside you.  It comes from ownership and responsibility.  When we talk about empowerment in the context of birth, it means owning your birth and taking responsibility for it.  Women tend to feel very upset about their births if they feel like they WERE NOT LISTENED TO.  Empowerment comes when we find our voice and USE IT.

We have strong voices.  Let's start using them. 


Carolyn said…
Thank you so much for this post! While having an empowered and/or natural hospital birth is possible, it can feel like preparing for and going to battle in ways that require every parent to not only to speak up for their wants, rights, and needs, but to also believe in those needs enough to give voice to them.
Allison said…
Your machine analogy is spot on. I was the naive mama who thought I could just tell the machine I wanted to "go natural" and that they would take care of me. Didn't happen. And then that I wanted a "vbac". Didn't happen. And then (3rd time's the charm) that I really, REALLY wanted a "vbac". I even went through 2 different hospitals while in labor trying to get the care I wanted with my 3rd birth. Didn't happen.

But I can't blame the machine too much--I brushed off things all through my Dr care that should have been red flags. I'm outspoken and obnoxious fairly often and I thought I could just demand what I wanted. Didn't work.

I learned that a mama needs to find care providers and support people who are in the habit of treating birth as a normal, natural event if that is what she desires. It really isn't fair to ask someone to do their job in a completely different way than they usually do, and then be upset when they don't listen. Get the right machine to do the job the way you want it done!

We hired a midwife and had a peaceful birth at home with #4 just a few months ago! HBAC was the right choice for me in part because of the emotional baggage I had concerning the way I was treated/not listened to in the hospital.
Anonymous said…
it truly depends on the hospital. i had a wonderful birth experience in a hospital, all natural with intermittent monitoring and a tub for comfort. my labor was very long yet my midwife chose to honor my birthplan to the T.
Enjoy Birth said…
I love this analogy! It is true that many care providers, nurses and hospital staff have their normal routines to keep things moving slowly. Many are fine with doing things differently with reminders... a GREAT way to know if your desires will be respected is to start using your voice and standing up for your choices before your birth even begins. Your care providers reactions will say a LOT!
Mama Birth said…
Thank you! And way to go Allison!
Sarah said…
It's really great practice to say "no" at pre-natal appointments...from getting used to the bewildered look on the nurses faces to asking, "what are the risks? benefits? what if I say no?" and hearing "you can refuse it." No...I'm not doing the glucose test, no...I'm not having an ultrasound at 38 weeks, no...I'm not having a vaginal exam today. Very empowering! Thank you for this post!