confined to bed after 4cm?

fergus51 · Nov 17, 2003

No, this is not normal. I would have expected that kind of thinking to be out since the early 80s! Ambulating helps speed labor and decreases pain in a lot of women. I would not have a baby in a place like this, and if you are, I would be very upfront with your doctor and the nurses before you get there.

**canoehead, BSN, RN** · Nov 17, 2003

Tell them where they can put their policies!

Seriously, if they are that uptight about ambulating you may find more problems if you inquire further. How do they feel about intermittent monitering, lots of position changes, massage, showering, birthing positions, episiotomies? How long do they wait for the placenta before they start yanking? Does the baby stay with you or go to the nursery ASAP? What about breastfeeding? Ask some more questions.

BETSRN · Nov 17, 2003

NO, that is NOT the way it is in lost of places. It sounds as if you are headed for a place that is really into interventions. I am an LDRP nurse and if the patient wants to deliver standing up, she can (although that's rare). The posts before me are great. I hope that you will look into other facilities and change health care providers if you can. The place you describe sounds like something out of the dark ages. if they feel that way about laboring women, I wouldn't trust their instincts about encouraging bonding and breastfeeding. Run, don't walk to another facility! Best of luck!

Betsy LDRP RNC

CT:(

SmilingBluEyes · Nov 17, 2003

Not where I WORK!!! best get with your health care provider and be VERY clear on your wishes in labor/delivery !! Talk to him/her face to face candidly about your wishes and expectations. No place I have worked would a woman be confined to bed at any stage of healthy labor and delivery, unless she has anethesia preventing ambulation.

A birth plan would be helpful for you to spell out, in writing your desires. There are several "shells" out there you can use to design yours. I leave you with a couple of web sites that help.

http://birthplan.com/

http://www.childbirth.org/interactive/ibirthplan.html

http://www.babycenter.com/calculators/birthplan/

http://pregnancy.about.com/library/weekly/aa031097.htm

But I want to caution you: BE FLEXIBLE PLEASE!!!!! TOO MANY familes are not. A birth plan is NOT a written-in-stone set of demands at all. The birth plan WILL be instrumental in documenting, in writing, the expectations you and your family have, so staff can best help you meet your goals for your birth experience.

Remember this: Things can change QUICKLY in labor/delivery and IF they do, deviations for emergency/urgent medical reasons MAY occur. There are TWO patients in my care as a labor nurse. You and Your baby...and sometimes. Sometimes, in rare cases, they supercede the wish for a totally natural experience. That is rare, but it can happen. Just make sure the staff is CLEAR on why each intervention they wish to do is being initiated--- ----informed consent is JUST THAT....understand what you are signing.

And, I recommend a DOULA if you can afford to hire one. THEY are wonderful support people for YOU and your family in labor and help express your needs to staff when you are distracted or feel unable. studies show their presence decreases incidence of medical interventions, including csections! Find one near you at this site:

http://www.dona.org

I hope this helps. I wish you a healthy and happy labor and delivery. Birth is a joyous rite of passage in a family's life. I hope yours is all you wish it to be! You and the medical/hospital staff are PARTNERS in making this happen! BE flexible, informed and safe. :kiss

littlemrs · Nov 17, 2003

Wow. Thank you guys for the very quick and thorough responses! So, I'm not crazy in thinking this is a bit of an insane policy.

During our tour I asked all the pertinent questions about the labor process, after baby is delivered, etc, and even though they are very mother-baby friendly, their labor policies are pretty, uh, old fashioned. They promote breastfeeding like nothing I've ever seen, and baby never leaves your side in the hospital unless their are complications, of course. So, they aren't completely in the dark ages.

I don't have a choice where I deliver because my doc is the only doc within a 120 mile radius who deals complications like mine (genetic clotting factor and I'm on heparin for the pregnancy, a big reason I don't want the epidural and am preparing for unmed, obviously) and that's where he delivers. He is very supportive of me wanting unmedicated, especially as it makes things less complicated for him (not having to 'reverse' my heparin unless it's an emergency, etc.) I know some docs like to take the patient off of heparin and then induce, but he'd rather me go into labor myself, and then just discontinue the heparin once I am in labor. If they need to then 'reverse' the heparin (in an emergency) that is still in my system, they can do that.

The L&D nurse said stirrups and breaking down bed are standard for delivery there, as are IV and continuous fetal monitoring during labor, etc. I've yet to talk to my doc about what all I learned yesterday but I am planning on it at my appt. this Wednesday. I am going to make a preliminary 'birth plan' and discuss with him. I totally agree about being careful not to put him or the nurses on the defensive with the birth plan, and I actually just read last night the long thread here about birth plans, and it was really helpful to get your guys perspective! I know flexibility is the key, but I still want my 'voice' heard, you know?

Knowing my doc (who has been pushing for all kind of updates in L&D since he arrived there 2.5 years ago) he will be much more accomodating than 'standard policy' of the hospital. So, I'm not too worried, I just want to make sure everyone else is on board when I'm actually in labor.

Oh, and if it's some insurance-company mandated policy to confine laboring moms to bed (which is what the nurse made it sound like), I'm completely willing to sign some kind of release so I can get out of that policy, if that's what it takes.

(Oh, and I will have a doula. :) )

SmilingBluEyes · Nov 17, 2003

Well all that remains as far as I can see is for you to try designing a birth plan....

GOOD LUCK!

dawngloves, BSN, RN · Nov 17, 2003

What are they going to do? Yell at you if you get back in bed?:chuckle I say poo on them! If you are laboring fine, no pit, no decels, sit in a rocker! Dance aroung the room! Squat by the bed! Silly hospital! :rolleyes:

L&D_RN_OH · Nov 17, 2003

Originally posted by littlemrs
I've yet to talk to my doc about what all I learned yesterday but I am planning on it at my appt. this Wednesday. I am going to make a preliminary 'birth plan' and discuss with him.

(Oh, and I will have a doula. :) )

I think that is a great plan. I would definitely talk to your doc about hosp. "policy", go over a preliminary birth plan, and if he agrees with it, ask if it is possible for him to write an order for the things you would like i.e. ambulating while in active labor, intermittent monitoring, etc. At my facility, if the doc wants anything besides monitoring per protocol (20 min out of every hour), they write an order. If there was a physician order, the nurses would be obliged to follow it, regardless of what their "routine" is. Good luck.

obeyacts2 · Nov 17, 2003

I cant believe that this hospital thinks a laboring woman needs to be in bed. Well, this is my opinion: it is YOUR Birth and YOUR body. If you want to be up, get up and walk or whatever. Remember, your have the right to refuse any treatment , even if your life is in danger (think of the pts that refuse blood products for example). Further, I think if more OB pts would stand up and refuse to foll0w some of these outdated practices, the facilities would be forced to change policies. In short tell them to *&&(( off and get up.

Laura

OBNurseShelley · Nov 18, 2003

Labor standing on your head and see how it makes their heads spin!! :roll

They need to get out of the dark ages, it's absurd, you should wait until you have the urge to push, then go to the hospital and see how they like that!

Btw, you can refuse anything and everything, including having an iv, continuous monitoring and being in bed. DONT let them scare you.

sounds like you have a good plan and good communication with your doctor!

good luck!

BETSRN · Nov 18, 2003

ACOG (American College of Obstetricians and Gynecologists) has a postion statement about intermittant fetal monitoring. This type of monitoring is an accepted standard of practice.

Also, the birthing bed does not have to be broken NOR do the stirrpus have to be used. There are footplates to use. It sounds as if the nurses there are of the old school and "have always done it that way". Maybe your doc will be able to change things a bit.

Insurance companines do NOT dictate that women have to be in bed. That is ridiculous. Women walk around with their water broken all the time. In fact, we leave woman at home as long as possible, broken water or not! As you have to deliver at that facility, I would do a lot of talking and a lot of squaking before you allow the treatments that you have described. The nurses there rae back in the dark ages. Have your doula with you but make sure that she does NOT try and interfere with any of the medical stuff. That is NOT within her scope of practice. If she can model labor support for the nurse that is with you, she'll ahve done a great thing!:chuckle