Saturday, July 23, 2011

Where to give Birth

Where should I have my baby?

To some there might be an obvious answer to this: “Women give birth in the hospital, duh.”

To others, there is a different obvious answer to this: “Women have been having babies at home for thousands of years…why should I have to go anyplace else?”

And yet to even others, they just aren’t sure. This post is for those folks…those that need a little help deciding what is best for them and their family.

First of all, giving birth in the hospital in the United States is definitely the cultural norm. Most women (as in some 98%) give birth here. This is fine, as long as women know a couple things about giving birth in the hospital. First of all, there are often many hospital policies that could affect their labor and birth and should be known ahead of time. Secondly, there are statistics that might make a difference and should also be known ahead of time. Unfortunately, many women just don’t know they should be concerned about it…after all, hospitals are there to do what’s best for their patients, right? Well, that’s one of the first things I’m going to comment on…pregnant women are not “patients”. They are “clients” that are in charge of their own birth experience – after all they are not sick (the majority aren’t, anyway). The hospital works for them. Not the other way around. So, even though the hospital is supposed to do what’s best for their “patients”, they sometimes have policies that may be more detrimental than not to a laboring woman and her progress.

For instance, it may be the hospital’s policy to give a laboring woman an IV Saline Lock “just in case”. It may also be a policy to have continuous Fetal Heart Monitoring. If a woman isn’t progressing quickly enough according to the hospital policy timeline, it makes it extremely easy to augment her labor with Pitocin…after all, she’s already got an IV so she’s all hooked up and ready to go. When a woman has continuous Fetal Heart Monitoring, it can limit her ability to move into different positions which helps labor progression, and based on the data gained by monitoring, can increase the likelihood of a provider recommending an unnecessary surgical delivery. Continuous Fetal Heart Monitoring is not a part of evidence –based care.

As far as statistics, the main one to be concerned with and to take close note of is the hospital’s cesarean section delivery rate. If a hospital has one that is as high as or higher than the national average (now at 34%), you might consider looking into the reason why and determine if it’s a reason you can be comfortable with. Also, you might ask your provider his or her rate and what in his or her mind would constitute the need for a surgical birth.

If you feel more comfortable with giving birth in a hospital, by all means, that’s where you should go. Just make sure you are aware of hospital policies before you go into labor and speak with your provider about how you would like to deal with them.

You could also choose a home birth. More and more women and families are choosing this option, for many reasons. First and foremost, home is where you are most comfortable. Many hospitals are now trying to create “homelike” atmospheres to help laboring women relax. They have figured out that homelike surroundings make things more comfortable, therefore help women relax. Even so, with all the beeping, buzzing, and constant monitoring in the hospital, it’s easy to see how some women are just more comfortable in their very own surroundings. Second, home has a mom’s own germs – ones that she and her baby’s immune systems are used to. This can be important - germs that are new to mom and baby can be more of a threat to both. Third, when a mom is laboring at home, she is in charge. There are no policies to worry about, no threat of impending interventions if things don’t go exactly according to “schedule”, and there is complete freedom to move around and let her body do what it was made to do in whatever way she needs to do it.

There is also an “in between” option of birthing in a Birth Center. This is kind of like a “home away from home” specifically designed for laboring and birthing moms. There is lower risk of intervention, but there are some medical things that can be done if needed. In South Dakota, a bill passed just this year allowing the licensing of Birth Centers in the state. Lawmakers are working on putting together the rules around this new law, so hopefully there will be up-and-running Birth Centers available to our birthing moms and families soon!

Above all, make sure that you feel comfortable with your choice of where to birth. Don’t let outside pressures take over, and make sure to listen to your own inner peace. Pray about your decision and go with it!

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