Updated: Dec 2, 2019
Births are natural, and most cases can go on without complications. But unfortunately, when complications do occur, the consequences could be devastating. Trying to mitigate these complications and trying to offer the best possible help when complications arise have led the design and evolution of what hospitals are today.
Despite that, you can rest assured that if your blood pressure goes dangerously high, or your baby's heart is abnormally racing, nurses and doctors will be able to notice it almost immediately and treat the issue most accurately. You will be safe. But this accurate treatment comes with a price: you should not leave your bed because you could fall; it’s better not to eat anything if you need an emergency C-section; you will have cables and beeps around you all the time because otherwise, how is it justifiable to have someone under medical care and not notice that something is wrong???
Psychologically, all women want to be safe. They also want to have a pleasant birth, with no unnecessary interventions done, and they want to feel respected and not treated as a potential liability. One way to optimize the balance between what is safe and what is over interfering is evidence. Therefore, you should be happy because there is favorable proof when it comes to minimizing interventions. Another fact you are going to love is that the medical community is also on your side. Many experienced nurses and doctors are comfortable with explaining everything you need to know about the procedures and to respect your choices.
In this article, we will offer some vital information on certain procedures and tools so you can understand why they are used and the benefits and drawbacks of each one. This way, you would be equipped to customize your experience to exactly meet your expectations:
IV fluids are one of the first interventions performed at hospital admission. It involves placing an I/V line (that will also work to administer medication like antibiotics or emergency drugs) and the continuous infusion of hydrating solutions. IV fluids are used to keep the mother hydrated during labor and delivery. This could be beneficial in the prevention of hypotension as some blood loss is expected. More so, IV fluid application is needed if the hospital policy is to prevent a mother from eating and drinking, or for mothers who vomit or in other conditions. The WHO recommends that mothers eat and drink freely during labor. Also, the pregnant body physiologically prepares for birth-related blood loss, by increasing the water content of the bloodstream (that's why dilutional anemia is normal during pregnancy, and why you may swell a bit). That means that if your blood loss stays within the standard limits and you can eat and drink normally, IV fluids are not imperative.
Maternal and fetal monitoring
It's understandable how you could think people are safer when being continuously monitored, but continuous monitoring is uncomfortable and has not been proven to improve outcomes in low-risk births, what is an acceptable compromise? Intermittent auscultation with a small Doppler equipment or a Pinard scope. Performed at needed intervals, these interventions are as effective with almost no toll on mother’s comfort.
Pitocin / Oxytocin
Oxytocin is a naturally occurring hormone. It produces uterine contractions and is related to mother-child bonding and milk secretion for breastfeeding. That is why Oxytocin is often used to somehow accelerate births in hospitals. In some scenarios, this procedure is useful for birth induction or in cases when the natural and lengthy birth process compromises fetal wellbeing, but its use should be very carefully indicated as it has some adverse effects. Natural Oxytocin is also capable of stimulating the production of endorphins (natural painkillers) in the brain. So with each contraction, the mother receives a wave of modulating substances to help her cope with the pain (our brain is acutely aware of pain related to contractions). It, however, doesn't work the same way when oxytocin is externally administered, so even when the labor is shorter, contractions are more intense and more painful. The fastest labor would imply that cervical, vaginal and perineal structures don't have complete time to dilate and relax. Therefore, you can expect more damage and more risk to have other procedures done like an episiotomy. And finally, directly related side effects have been described as nausea and vomiting and some rarer but fatal ones. Oxytocin is indicated to treat different conditions during labor, and it's the norm for the prevention of postpartum hemorrhages, but it should never be used to prevent delay of labor.
This topic is so broad that it will be treated in a different article. As broad as the scope may be, the use of pain medication is very personal. It’s an entirely human and understandable action for doctors to offer pain relief and for mothers to ask for it. Labour pain may the most intense pain you will (hopefully) ever experience, and you are offered an accessible way to ease it, who wouldn't take it? We use painkillers for headaches; we use anesthesia for surgeries, why shouldn't an epidural be used for pain of contractions? But really, it's not so simple, epidurals have evolved with time, and they are becoming safer, but there are well-known consequences of its use and you should be familiar with these consequences before accepting one. To be able to resist the urge to ask for pain medication, you will need to rely on your knowledge of what is best for you when you think you have reached your pain threshold. The use of pain medication is your choice only, but you should know what to expect from its use, we are preparing a special article on it right now.
It consists of the amplification of the birth canal by performing a moderate cut in the skin and muscles of the perineum as a way to hasten the delivery of the head and control the occurrence of lacerations. An episiotomy will also need to be stitched after. The use of it is very variable among practitioners, being more used by OB/Gyn than midwives, and its use has generated an unending debate. So, it is true, an episiotomy could prevent a more severe laceration (such as a tear that involves the perineum and rectum) but it is impossible to know the degree of its significance beforehand. If any occurs, in slow, controlled births, a tear can be prevented even in first pregnancies. This is definitely a conversation you would want to have with your doctor ahead.
In conclusion, if you are healthy and decide to give birth in a hospital, it doesn't mean that you won't be able to move, eat or drink and will spend hours attached to a monitor and have a bunch of drugs given to you. Most of these things are not essential, and surely you will find many health care providers that will understand your expectations and assist you in having the natural and safe birth you want to have.
Consider other birth alternatives like Water birth or Home Birth.