Clinical

ETA: My OB was NOT happy with what happened!!! She talked to us about natural birth and how she’s totally on board with our plan; she went over every item of our birth plan and helped us make edits and said we didn’t want anything unreasonable. She also got the head of the department on the phone, and the dept. head gave me a personal apology, the assurance that we and our desires would be taken seriously, and that the policies and procedures outlined during the tour were absolutely NOT graven in stone and that the staff would be happy to accommodate our needs. So I feel better. Not 100% because it’s going to depend on who’s working on the big day, but it went a long way toward easing my mind knowing that my OB is both totally on board with our wishes and was both shocked and displeased with what happened.**

Last night was our first prenatal class and hospital tour. It was a disaster. I did not like our hospital. I would go so far as to say I hated the woman running the class and giving the tour.


The hospital: I will start on the upside and say that the facility itself is quite lovely. Lots of nice hardwood floors in common areas, half the rooms have beautiful views of Honolulu and Waikiki and the other half have views of the Pali mountains. So that’s the upside. The downside is that all I’ve ever known of birth centers is York Hospital and Mercy Hospital in Portland. Both of those places you labor, deliver, and recover all in the same room. They are perfectly nice, pleasant places where I would be happy to deliver. Mercy Hospital in particular was totally wonderful. How can you not like a staff of nurses who sneak the free formula samples out of the promotional diaper bags and are willing to work Thanksgiving to ensure that they’ll have the day off on the off chance the Pats will be in the Super Bowl?

My first red flag was when our nurse/tour guide mentioned she was a “post-partum dept. nurse.” From that I inferred, correctly, that we would be bounced from one room to another. At our hospital, you deliver on one side of the floor and then they move you to another room to recover. You also have to specially request having the baby have its first bath in your room which they “don’t like to do because it takes an extra nurse but they will if you ask.” Um, what? Why is it hospital policy not to automatically do these things in the room with the mother? My sister never had to ask, it was assumed everything would be done with her. Why am I being made to feel like I’m asking for special favors and putting people out because I want to see my baby’s first bath?!

Their standard operating procedure is to have full monitoring and then after labor, they whisk the baby straight off to the warmer instead of letting the baby do immediate skin-to-skin with the mother. You get another hour in the delivery area where you can try to breastfeed. Then when you get moved into your recovery room the dad and baby go to the nursery for another hour of tests and fiddling. All that is a big no for me. Why is a nurse going to be the first person that my baby has contact with? I gave birth! I want to hold it right away! It’s also not consistent with what I saw with Erika’s birth. Owen stayed with Erika for the whole afternoon, was automatically bathed in the room, never left her side unless she asked for a break. I know for a fact he was plopped directly on her chest as soon as he emerged because she mentioned how one minute he was still in and the next minute looking at her like “What the hell just happened?!” It was a powerful-sounding moment. I don’t want my nurse to have our moment.

Another bad thing isn’t really the hospital’s fault, but I am feeling rage-y today so I’ll mention it. It’s my recovery stay and that’s related to the insurance companies–you get two full nights of recovery after your birth, starting at midnight. If you give birth at, say, 11:55pm, your first night starts five minutes later. The nurse recommended that you “try to hold on” until midnight if you find yourself in that situation. Yes, let me just hold back my 8 pound newborn so I can get the insurance to cover sufficient recovery time. I’LL JUST SQUEEZE MY KNEES TOGETHER.

When we were in the delivery tour area we also happened to be outside the door of a woman giving birth–you could hear the nurses and people in the room howling and carrying on and cheering so loudly that you couldn’t hear the woman deliver!! Not okay. No cheerleaders for me, please. This isn’t the 100M or the balance beam, I don’t want to be cheered on like a horse out of the gate! That also goes against a huge component of hypno-birthing–gentleness is also largely silent and quiet. So that was the hospital.


The nurse giving the tour and teaching the class…ohhhhh the nurse…where to begin. I know she’s just one person, but she teaches all the prenatal classes and she’s a post-partum nurse to boot, so someone thinks well enough of her to make her the public face of the hospital maternity center. I have to wonder how much of her attitude and philosophy are the hospital’s as well.

It started when she mentioned that this is a teaching hospital and some people get upset about the residents and such, but it was good to have a lot of people and options so “try to just utilize the staff.” Mrgh. How many people will really need to look up my shorts, anyway? Then there was the monitoring, which will be constant, which led someone to ask a question about “preferences,” or the birth plan. She said, and this is a direct quote: “Yeah, you can write them down, but we find nine times out of ten that unrealistic parents get their hopes up and it falls apart. Plus their babies are more likely to need extra help because their plans don’t allow us to do our interventions.” Oh. My. God. What is this preventative intervention business? Is that like a pre-emptive strike on Iraq?! Are you looking for WMD in my uterus?! So discouraging and negative and fear-causing.

So then we went on to the recovery room and she mentioned that if you’ve had a c-section, you’ll be moved to the room by gurney. And here’s where a woman who took an entirely different approach to her birth became the vehicle for showing me what I had to fear.

This woman in our class–who happened to be the only mom there without a partner or friend with her that I could see–was really upset by that. She mentioned she knows she has to have a c-section and the idea of the gurney kind of freaked her out. Nurse: “Well, then why are you having a c-section?” And the nurse asked this in a room with 30 other people. Well, nurse, since you aren’t attending the birth, it’s none of your damn business why, and it’s certainly not ours. The woman replied “medical reasons” which is more than I would have said with all eyes on me. The nurse goes “Oh, okay, I was going to say, can’t you just flip that thing?” She said it somewhat jokingly but still–what business is it of hers if she isn’t going to be at this woman’s medical team? What of patient privacy? When I hear “have to have a c-section” I assume that there is something like placenta previa, etc. going on, none of which I would care to discuss publicly. And what an insulting thing to say if there were women in the room who had breech babies that they couldn’t get to turn–way to make them feel like failures. And the topper: “But yeah, don’t worry about the gurney. You’ll be medicated.” Meaning she’ll be so doped to the gills that she won’t give a shit, and this is supposed to be a comfort to her. I certainly felt better having a nurse confirm that in the event of a c-section I would be high as a kite and totally incapacitated.

So we chatted a bit more about amenities of the rooms–no WiFi in the hospital so y’all have to wait for your photos, by the way–and thankfully she did mention that the baby can stay overnight with you if you want. The poor c-section girl apparently hadn’t had enough and asked if it was possible to have the baby stay in the nursery and be brought in for feedings. Perfectly legit question since she seems to be doing this alone and will have just had major abdominal surgery. C-Section cracked a joke “Already I’m a terrible mom, huh?” The nurse thought that teasing her back with “Oh, guess you aren’t going natural at all, huh? C-section, not going to have the baby room in with you…someone call DPS!” was appropriate. Her tone was kind of jokey, but not really. The hospital doesn’t seem to put much of a premium on naturalness anyway, and your bedside manner is to tease her back instead of giving her a comforting smile and maintaining neutrality? And again, what an insulting thing to say if other couples had planned to utilize the nursery for nights. I was relieved to know I could keep the baby with me but my choice and their choices are different, and none of them are for her to editorialize on.

From everything else she said, she just seemed really cold and impersonal and kept making all these references to “killing the pain if you need” and “we may have you walk around to help get things moving. That was another huge red flag, as the hypno-birthing guidelines would have you avoid that kind of talk. If someone keeps insisting that you should be in terrible pain, you WILL be in terrible pain. If someone keeps suggesting that you should be moving along faster and should rush, you WILL rush and do so artificially. Even Tom, Mr. Sunny-side Silver Lining, was horrified by her insensitivity. And after reading about natural birth centers, he was surprised to see how the rooms, though well-appointed, were still cold and clinical places.

This woman, who teaches the prenatal classes, who works on the floor, is the person who the hospital chose to have as their ambassador to new parents. Wearing a wink-wink smile and speaking in sing-song the whole time, she was basically every cliche of a clinical, fear-mongering nurse that I had read about in books, medical forums, and articles. Underneath the chipper exterior she seemed jaded, insensitive, discouraging, negative, and anxiety-causing. This is not the place that I had imagined. What she represents is not what I want.

I cried all the way home. It’s the first time I’ve felt anything like scared or negative regarding birth. I hated it. Every fiber of my being was and is telling me that these people are not going to take us seriously, or respect what I believe are very modest wishes–to be allowed to progress at my own pace, without being scared or pressured, with my wonderful husband gently coaching me.

I’ve said it before, but I am not opposed to the medical profession or necessary intervention. The staff does this every single day. I want to learn and utilize their experience to augment my own understanding. I want to be flexible in the face of medical necessity. My birth plan is really a list of preferences, and it all boils down to being treated like sane people about to become parents, not a woman under the influence of a traumatic medical event. I do NOT want some staff member to undermine every good, hopeful feeling that I have because what I want might not fit exactly into the pre-established routine.

I have an OB appointment today, and I really like my doctor. We’re going in to get options. At this point, I’d rather have Tom take a paramedic class and kick it at home in my tub than go back.

Advertisements