# I don't understand "show up to the hospital pushing"



## veryhappydog (Jun 9, 2009)

I don't understand why so many women will give advice to "show up pushing" at the hospital, yet are not willing to UC. I keep getting the impression that a lot of fetal distress or problems are picked up during monitoring, and don't just spontaneously happen as soon as the baby exits the womb. I'm personally a fan of UC and plan to do it, so I don't understand why if someone's comfortable with no monitoring whatsoever, they still need someone to 'catch the baby'. Any help here? I'm genuinely puzzling over this one, not trying to start a debate either way.


----------



## lunita1 (May 12, 2008)

Well, two of the "scary" and somewhat unavoidable childbirth emergencies are shoulder dystocia and hemmorhage. Also, keeping an eye on baby activity (or lack thereof) is a form of monitoring.

I dunno... I've had a "show up at the hospital pushing" birth (not planned that way), and a birth with 22 hours of regular monitoring. Even the worst hospital couldn't have ruined the first baby's birth/performed unnecessary interventions that could have led to problems. The second one could have gone very differently in another hospital with more interventionist policies (I had ruptured membranes for over 30 hours, and mec in the water). Usually, I don't think women really get the advice to show up pushing... the advice is more along the lines of staying at home until labor is undeniable and progressing regularly. There's usually lots of time between the first twinge of "is this labor"? and "I need to push this baby out right now", especially with a first baby...


----------



## blessedwithboys (Dec 8, 2004)

fear of the unknown, lack of trust in one's body, fear of legal prosecution if the baby dies, desire to avoid clean-up at home, desire to placate partner, desire to take advantage of hospital stay as a break from household duties/older kids, desire to be close to OR "just in case" in VBAC women


----------



## Plummeting (Dec 2, 2004)

That's an interesting question and I've never considered it, perhaps because after my two labors (short/intense/very painful and precipitous/ridiculously intense/horrendously painful) I know that if I'm already to the point where I'm almost pushing #1. it's too late to go to the hospital anyway and #2. there is no way in hell someone is getting me into a car. However, I can tell you why I'm not interested in UC, even after having a home birth during which the midwife was only present for the last ten minutes of pushing (out of a total of maybe 15 or something). For me, while I'm perfectly capable of learning what I need to know to do it completely alone, I don't _want_ to do it completely alone.

DD1 had the cord wrapped around her neck three times. It didn't cause any problems at all, but the midwife (CNM at a hospital) had to loop it up over her head for me to push her out safely. Not a big deal at all, but not something I want to have to think about unless absolutely necessary. I was prepared for this possibility at DD2's home birth, especially once we realized that, due to a precipitous labor and a road block we didn't know about, our midwife really might not make it on time, but I just didn't want to have to deal with it. I wanted someone else to notice those kinds of things so that I could concentrate on the work at hand. If I had another baby, I'd want a midwife again, even though I know odds are she'd only get there at the last minute. DD2's shoulders didn't slide right out like they should have. I'm not trying to be overly dramatic, so let me be very clear that there was no real emergency, we did not have a shoulder dystocia or anything like that, but she was a little sticky and the midwife definitely was a help in maneuvering her out. Again, not something I want to have to worry about.

I know that there aren't as many problems that would require monitoring in really fast labors, so my perspective is different than some people's. For me, there's no reason for anyone to be monitoring - the baby is coming and it's probably coming before anyone has time to notice anything wrong. But I want someone else there to notice if the cord is around the neck and therefore needs to be unlooped or to help me if the baby is a little sticky. Just my opinion and experience.









Edit: Sorry, this didn't seem so related to hospital births, but my point was that I can see why someone might want to have someone _else_ catch the baby, even if they didn't want to _labor_ at the hospital.


----------



## AmyKT (Aug 20, 2009)

Quote:


Originally Posted by *blessedwithboys* 
_*fear of the unknown*_, lack of trust in one's body, fear of legal prosecution if the baby dies, *desire to avoid clean-up at home*, desire to placate partner, desire to take advantage of hospital stay as a break from household duties/older kids, desire to be close to OR "just in case" in VBAC women

These in bold are pretty much it for me in a nutshell, especially the fear of the unknown, and I have a lack of desire/drive to acquire of all the things I would need on my own. If my insurance covered it, I would seriously consider a homebirth with a midwife, but I am not especially interested in preparing everything I'd need for a UC, and I've seen some very lengthy supply lists. Also, my DH would freakin' freak out.

Honestly, I don't want to show up quite at the pushing stage because I'd like to settle in and get comfortable, but an hour or two at the hospital before pushing would be enough.


----------



## briome (Aug 10, 2007)

I think a lot of times this is mentioned is in an area where there is high intervention/c-section rates in ALL the local hospitals/care providers, especially if a specific woman has been threatened with a certain treatment regardless such as "your only option is to schedule a c-section" or " Everyone is required to be in bed with a strapped on monitor at this hospital" or some other nonsense.

If you live in an area that is consistantly respecful and you have a variety of choices for care, I don't think it would matter TOO MUCH when you went in.
I also agree with a pp that monitoring during labor is really overdone and also are some hospital's need to augment or otherwise fool around with a laboring woman.

SOme people feel a need to give birth at the hospital for various reasons and laboring at home can be a nice part of the process and still get the need for that hospital care (because so many people would never consider a homebirth, also for various reasons)

I think primarily it is the first thing I mentioned, when the hospital is a hostlie enviroment for a particuar woman for a certain reason.


----------



## RedOakMomma (Sep 30, 2004)

I like delivering at the hospital (I love my OB and have had great natural births with his care). I also like laboring at home, and would prefer to avoid hospital policies like no eating, staying in the room, etc. I don't like the idea of LITERALLY "going in pushing" (though it happened to me once)...I'd rather go in just before transition and get settled...having a hour at the hospital would be a lot less hectic than last time, when it was only about a 1/2 hour!









Laboring at home is nice, but the birthing at my hospital is also nice. I like having both.

I'm also GBS positive, so I feel most comfortable getting antibotics by IV while I'm laboring (or pushing, as it turned out).


----------



## cappuccinosmom (Dec 28, 2003)

If a person plans on hospital delivery (for whatever reason, and they may have a perfectly valid one), and wants to avoid interventions, going in late in labor is one of the best ways.

With my three, I arrived around 7-8 cm and feeling pushy. It worked out perfectly. They didn't have time to mess with me.









I have a variety of reasons why UC is not for me, and feel no need to defend them, really. Since my only other option was hospital birth, "going in pushing" was my defense against unwanted interventions.


----------



## CherryBomb (Feb 13, 2005)

I don't understand it because having been through transition, I don't see how the hell I could have made the 45 minute car drive.

I have absolutely no desire to UC, ever, under any circumstances. But I also want to make sure labor is established before going to the hospital. With my vba2c I got there at 7cm, which was pretty good. I'd prefer more like 5 or 6 so the baby can be properly monitored, but it worked out well. I had two days of regular contractions that petered out before labor really got going, so I'm glad I didn't rush to the hospital right away.


----------



## philomom (Sep 12, 2004)

Quote:


Originally Posted by *cappuccinosmom* 
If a person plans on hospital delivery (for whatever reason, and they may have a perfectly valid one), and wants to avoid interventions, going in late in labor is one of the best ways.

With my three, I arrived around 7-8 cm and feeling pushy. It worked out perfectly. They didn't have time to mess with me.









I have a variety of reasons why UC is not for me, and feel no need to defend them, really. Since my only other option was hospital birth, "going in pushing" was my defense against unwanted interventions.

I could have written most of this post. I came in a 9 centimeters each baby. Had a C.N.M. help me and all went beautifully.


----------



## emnic77 (Sep 12, 2009)

Quote:


Originally Posted by *cappuccinosmom* 
If a person plans on hospital delivery (for whatever reason, and they may have a perfectly valid one), and wants to avoid interventions, going in late in labor is one of the best ways.

With my three, I arrived around 7-8 cm and feeling pushy. It worked out perfectly. They didn't have time to mess with me.









I have a variety of reasons why UC is not for me, and feel no need to defend them, really. Since my only other option was hospital birth, "going in pushing" was my defense against unwanted interventions.


This. I wasn't ready for a homebirth with my last baby, for emotional reasons that I won't get into, so I wanted to go to the hospital late enough that there wouldn't be enough time to fight about the antibiotics and GBS+ status specifically...so, getting there at 8cm was the best way to do that. They didn't argue because clearly at 8cm it was a moot point, I wasn't going to get the "right" dose in time anyway. He was born less than 3 hours after we got there, with zero intervention (not even a heplock), with a good nurse that contorted herself every which way so I wouldn't have to stay still for fetal monitoring, and labored through transition in a tub in the dark with no one around but my dh. My CNM closed the door and said "call me when you need me." we left 10 hours after he was born.


----------



## bandgeek (Sep 12, 2006)

I imagine a lot of women would want to labor at home, but not necessarily deliver there. It's not really a mystery to me. Women prefer all sorts of different things when it comes to birthing.

This is something I'm considering if I have another child because of my history. My DD had a severe brain injury and I'm not sure any midwives would take me. I'm not 100% comfortable with a UC. But I'd hate to go into the hospital before 8-9 cm and have them force all sorts of interventions one me. So there's one scenario I guess. As far as being "ok" with no monitoring but not feeling comfy with UC...for me they have nothing to do with each other. I'm ok with no monitoring because I know by the time the baby does into REAL distress there's a good chance you can't get them out in time anyway (which is why continuous fetal monitoring and an increase in c-sections hasn't improved fetal outcome). Going in would be more to do with not messing with clean-up and avoiding legal problems if something went wrong. If any of my future babies goes into major distress we won't be resuscitating anyway if they can't breathe on their own without intubating.


----------



## sanguine_speed (May 25, 2005)




----------



## ColwynsMommy (Aug 2, 2004)

I'll tell you why I think "show up pushing" is a bad idea. As a disclaimer, let me say that I have no problem with people who don't want to homebirth for whatever reason. If people feel best about birthing in a hospital, go for it! Give birth wherever you feel safest.

That said.. I think if you want to wait until you feel like pushing to go to the hospital, you need to be prepared for a UC. I've had precipitous pushing stages with all of my children, even my first. My first birth, in the hospital, I pushed for maybe ten minutes tops. The OB didn't even have time to put her gloves on, she rushed into the room and caught the baby as he slid out. There's no way they could have predicted that.. my OB actually thought I might end up with a c-section because the baby didn't engage at all until well into labor - they thought my pelvis might be too small. My next two were pretty much the same. Now, I only live 5 minutes from the closest hospital, but there's no way that I would get there in time. And while I think homebirth is great, had my third at home and am planning another homebirth, I would not want to risk giving birth in the car. Nor do I think it's a good idea to knowingly risk UC without also preparing for UC.

I do feel bad for women who have no good choices, who can't homebirth for whatever reason, but are likely to end up with a terrible birth in the hospital. If they want to show up pushing, fine.. but they'd be most responsible to also prepare for a UC in that case. If you want to give birth in a hospital, then do so responsibly. If you want to UC, then do so responsibly.


----------



## sanguine_speed (May 25, 2005)




----------



## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *veryhappydog* 
I don't understand why so many women will give advice to "show up pushing" at the hospital, yet are not willing to UC. I keep getting the impression that a lot of fetal distress or problems are picked up during monitoring, and don't just spontaneously happen as soon as the baby exits the womb. I'm personally a fan of UC and plan to do it, so I don't understand why if someone's comfortable with no monitoring whatsoever, they still need someone to 'catch the baby'. Any help here? I'm genuinely puzzling over this one, not trying to start a debate either way.

I don't think I could handle an emergency if the baby came out and was unable to breathe or had some type of unforeseen health problem that quick action in the hospital could save their life. I'll labor at home, but I have no medical training that would make me comfortable with handling a newborn that may not be healthy.


----------



## ColwynsMommy (Aug 2, 2004)

Quote:


Originally Posted by *sanguine_speed* 
I've always taken the "show up pushing" idea to mean show up very late in active labor rather than literally to show up while you're pushing.
Definitely NOT to mean don't even start to go until you are pushing!

I still stand by my assertion. Even if you plan to get there when you're 8cm, there's no guarantee that active labor will be textbook. It might go an awful lot faster than you expected. Again, for my births.. I have very long early stages and do most of the dilation very, very quickly. My third, I went from 2cm to babe-in-arms in under an hour--the first half hour of which I had no idea that it was progressing so quickly.. so that would have given me under a half hour, once I realized what was going on, to get to the hospital.

All I'm saying is.. if you're trying to cut it that close, don't count on a textbook labor, because you might end up UCing when you had no intention to. And better to get to the hospital early or hire a midwife for a homebirth than have a medical emergency and not be prepared at all. If you want to plan to show up at the hospital very late in labor, then prepare for a UC just in case, that's all. I'm assuming most people who want to deliver in a hospital are worried about safety and having appropriate medical attention.. so I hope they'd be responsible about covering all their bases just in case.


----------



## accountclosed3 (Jun 13, 2006)

i UC myself, but i recognize that it's not for everyone.

for my money, i think that everyone should be prepared to UC because you never know how quickly things will go--whether you will get to the hospital or the midwife would arrive or whatever. KWIM?

but, i can understand that people may not *want* to choose to UC. prep for it, sure, but not actually *plan* it.

it's perfectly valid to choose otherwise, and it's a great idea to go later in labor (or when pushing) so that one is less likely to be subjected to policies and procedures that would lead to interventions, yk?


----------



## JorgieGirl (May 13, 2006)

I don't see why there is such an issue surrounding a woman's choice to wait til late labour if that's what she's comfortable with.

Personally, I think any pregnant woman should know the basics of birth and what to do in the situation of being alone at home (or elsewhere) if the baby decides NOW is the time it needs to come.

Instead of being all judgey about a perfectly valid choice- that in the great majority of cases will turn out just fine, and very much more than likely help to avoid unnecessary interventions- we focus on supporting a woman's choice to birth her baby the way she's most comfortable.


----------



## erin_brycesmom (Nov 5, 2005)

I've pondered this before OP so I totally get where you are coming from with this question. I get the responses too. There are reasons but I think our birth culture has put an awful lot of focus on the dangers of miso, pit and epidurals and for so many women, their only desire is to avoid those things. I would like to see more focus on the risks associated with 2nd and 3rd stage provider management. There needs to be more awareness about that IMO. I think the most harm can be done during those stages and women are going into the hospital right when they are happening and those stages are being managed in a panic and often without enough time for a woman to relay her desires to said provider.


----------



## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *zoebird* 
for my money, i think that everyone should be prepared to UC because you never know how quickly things will go--whether you will get to the hospital or the midwife would arrive or whatever. KWIM?

ITA with this, especially after DD2's birth last month. I don't _want_ to UC, but even if I hadn't planned on waiting until the last minute, I wouldn't have made it to the hospital in time. Granted, I was planning a home birth, but it could just as easily happen to someone planning a hospital birth. The hospital we would've gone to is 45 minutes away. My birth actual labor was *52 minutes* long. There was a road block. We would've had to wait for care for DD1 to arrive or drop her off somewhere or get her up and get her ready if we'd been taking her with us. There's just no way we would've made it to the hospital in time and my midwife _almost_ didn't make it to our house in time. In fact, I have 2 midwives and only one of them made it in time. The other was abotu 5 minutes too late.

Colwyn, an unintentional UC could happen no matter WHAT you do. You could go from 2 to 10 in an hour or you could go from 0 to 10 in 30 minutes or you could not have been checked and only know that you went from first real contraction to babe in arms in 52 minutes, like me. How dilated you are when you started doesn't actually even matter, because you can go from 0 to 10 in 30 minutes. No one should ever think that an accidental UC won't happen to them because they aren't dilated "enough" or something.

In spite of all that...I know what to do once the baby's out. I know to check for a cord around the neck and then unloop it if it's loose or hold the baby's head to the thigh and let them somersault out if it's not. I know to get on hands and knees if there's a prolapse or a shoulder dystocia. BUT, I don't want to worry about that. I don't want to UC.


----------



## St. Margaret (May 19, 2006)

Yeah, we got the "show up pushing advice" and took it to mean, show up when you feel like you're going to start pushing soon. We also live very close to the hospital where our super natural-friendly OB works. And we had a great childbirth instructor/doula over at our place for a little while before heading over, which made us feel like someone who's seen lots of births was keeping an eye on things, could tell probably how close I was, etc. It was perfect, b/c I was entering transition, had a quick trip in the car (which wasn't fun but was okay) and then got settled in, worked through the rest of transition very comfortably with no interventions, and pushed DD out. But my OB is actually right there with you the whole time you push, and things like shoulder dystocia are the reason I'm not comfortable with UC. I like having an expert in getting baby out, should expert help be needed/useful. We very well might do a HB this time, but at the time, that was our OB under insurance, the whole birth was free, and he was basically like a birthcenter midwife, so we went with it!

ETA: I agree that EVERYONE should be ready for a UC. My favorite birth books all seem to have chapters on this, so you can be prepared for the possibility. But if I was stuck at home, I'd be calling up my birthy friends who all live within walking distance fast, too


----------



## rainbowmoon (Oct 17, 2003)

why does it matter to some so much what other women do? I feel like it's probably no ones business in all reality. I planned a UC and transferred during transition due to meconium. Turns out I made the RIGHT decision there because I also had a placenta issue and myu baby was FULL of meconium. I think if a woman feels her instincts say to show up crowning have at it! It's not fun but hey it helps avoid monitoring and interventions so that's what some women are trying to avoid. Not everyone has to agree with UC or hospital birth but geez do we have to keep judging each other for our birth choices?


----------



## emmalizz (Apr 14, 2009)

.


----------



## ColwynsMommy (Aug 2, 2004)

Quote:


Originally Posted by *rainbowmoon* 
why does it matter to some so much what other women do? I feel like it's probably no ones business in all reality. I planned a UC and transferred during transition due to meconium. Turns out I made the RIGHT decision there because I also had a placenta issue and myu baby was FULL of meconium. I think if a woman feels her instincts say to show up crowning have at it! It's not fun but hey it helps avoid monitoring and interventions so that's what some women are trying to avoid. Not everyone has to agree with UC or hospital birth but geez do we have to keep judging each other for our birth choices?

I didn't think we were being judgy. If someone wants to go to the hospital, go for it. I just worry that people will assume that making a plan to get to the hospital just in time to push the baby out relieves them of their responsibility to educate themselves on what to do in case they don't make it. People who plan homebirths (UC or otherwise) generally seem pretty well educated on what to do in case of an emergency. A lot of people I know in real life, who plan hospital births, have no clue. I don't care where people give birth, so long as they're acting responsibly.

And I do agree that *everyone* should be prepared for UC regardless of where they plan to give birth, but I think those who are hoping to get to the hospital in early labor are more likely to actually make it there.


----------



## RedOakMomma (Sep 30, 2004)

A lot of women who have hospital births may "have no clue," but if a woman is planning on laboring at home I'm betting many of them DO have a clue of what to do in emergencies. I know I do.

Women who make these choices aren't idiots just because part of their birth choices involve a hospital.







In fact, I'd guess that very few birth-uneducated women choose to labor at home. We labor at home, and make the choices we do, because we HAVE educated ourselves.


----------



## philomom (Sep 12, 2004)

Quote:


Originally Posted by *RedOakMomma* 
Women who make these choices aren't idiots just because part of their birth choices involve a hospital.







In fact, I'd guess that very few birth-uneducated women choose to labor at home. We labor at home, and make the choices we do, because we HAVE educated ourselves.









Thank you.


----------



## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *redoakmomma* 
a lot of women who have hospital births may "have no clue," but if a woman is planning on laboring at home i'm betting many of them do have a clue of what to do in emergencies. I know i do.

Women who make these choices aren't idiots just because part of their birth choices involve a hospital.







in fact, i'd guess that very few birth-uneducated women choose to labor at home. We labor at home, and make the choices we do, because we have educated ourselves.

ita!


----------



## phathui5 (Jan 8, 2002)

With my first baby, I showed up at 8cm because I figured the longer I stayed home, the less the hospital could annoy me. I really didn't know that homebirth was an option in my area, as I didn't know any MDC-type moms before I had ds1.

My next three were out of hospital births.


----------



## TCMoulton (Oct 30, 2003)

Quote:


Originally Posted by *blessedwithboys* 
fear of the unknown, *lack of trust in one's body*, fear of legal prosecution if the baby dies, desire to avoid clean-up at home, desire to placate partner, desire to take advantage of hospital stay as a break from household duties/older kids, desire to be close to OR "just in case" in VBAC women

Honestly the bolded is a bit offensive. Just because a woman chooses to birth in a hospital does not mean that she doesn't trust her body. I don't understand why the choices a woman makes regarding her birth matter to anyone else - if you (in general) do not want to be judged for birthing at home/choosing UC/choosing VBAC/ whatever then the mom who chooses a hospital birth deserves the same courtesy.


----------



## accountclosed3 (Jun 13, 2006)

i think it's fair to say that there isn't really a judgment inherent in the honest questioning of both the use of this term and also why or whether or not people are prepared to birth unassisted.

and when one is first learning about UC (don't know if the op is, just assuming), there tends to be this time of really questioning the whole thing. truly, why aren't more woman doing this? what is going on with our culture? and what the heck is up with me?

i've been there, so i know. probably hurt a lot of people--even though i *do* support birth choices and options. so, you know, i am just saying.

the other thing here is that listing out a group of possible reasons why people are choosing the hospital, and some of those reasons being "less than optimal" such as lack of trust in one's body or in birth, does not mean that every person who chooses a hospital birth will be choosing based on that reason in part or alone.

i know a lot of people who choose not to birth at home because of clean-up issues anf fear of risks, and then have to choose between the birth center and the hospital. i don't know how they choose, but often it doesn't have to do with lack of trust in their bodies.







they have other reasons (both known and unknown).

i know people who choose hospitals because they have very serious medical concerns even if they may not be obvious issues that weigh heavily in their decision. a friend of mine is overweight--and lovely and beautiful and great and sexy and all of that--but she is prediabetic. so, she wants a doctor and hospital birth to help her throughout, and she goes with a midwifery team of CNMs who work with OBs. she had no problems during pregnancy, labor, or birth related to her blood sugar levels, etc--and had a healthy, normal, vaginal birth at the hospital.

so, you know, people have their reasons. but it doesn't mean that anyone who is making a list assumes that a given individual choosing the hospital birth inherently embodies all of those element sof hte list.







kwim?


----------



## elanorh (Feb 1, 2006)

While I have precipitous labors -- like most women in my family -- having talked with friends, it seems that those lightning-fast labors are less common than the longer labors (my second baby, for instance, I knew I was in labor at 5:30, we got to the hospital at 6:00, baby was born at about 6:20).

I think for many women, laboring at home until they are feeling near-transition (depending on distance from the hospital or even birthing center) is advantageous because she is in HER OWN territory. She can do whatever she wants, eat, drink, wash the ceiling, whatever. She can get in her own zone. And the farther along she is in that process before arriving at the hospital, the less likely that interventionist hospital policies will derail things and stall her labor out. I've got several friends who have described this very thing happening to them. Of course, birth at home (UC or otherwise) might have been a better option for them; and I do mention homebirth to people. But if their only option is a hospital, better to show up late than early!! Sometimes all it takes is one pushy nurse to start the cascade of interventions.









UC isn't a choice all women are comfortable with - and frankly, I think most fears that people have about UC don't involve the "4cm" phase of labor. They involve PPH (dh's huge fear), or shoulder dystocia, or baby having trouble breathing .... the catastrophic fears. And, sure, a mother can and ought to know at least a little about how to deal with those issues in the absence of assistance, but not all mothers want to give birth without assistance. Much as we might like to rail against the father influencing how/where a birth occurs -- at the same time, these things do get negotiated. If I thought my dh could really become comfortable with UC, we would have one. But he's terrified of them (and, we have had awesome natural births at the local hospital, thanks to a good midwife-minded OB and my quick labors). Until July, lay midwife assisted homebirth isn't an option where I am (new law just passed







) and even after that, who knows how long it will be before we have a midwife right here in town (because given my fast labors, how likely would a midwife be to arrive on time, when she'd be traveling most likely at least 2 hours to get here?).

I have told people to 'wait 'til you're pushing,' and I'll keep telling them that. It's usually a first-time mom, or mothers who want natural births after a high-intervention first birth. I doubt many of them actually wait 'til they're pushing.







But I think so many people panic and head to the hospital as soon as they realize they're in labor, then stall out upon arrival and end up on pitocin, then an epidural, then with their water broken, and "on the clock" for a c/s --- where, if they'd just stayed home and more relaxed a little longer, they might have avoided it all.... I do also tell friends when we're talking about this, that if their mom had fast labors, then it's possible that their labors will also be fast (I've a friend expecting her first, whose mother nearly gave birth to her in the car - first and only baby).


----------



## erin_brycesmom (Nov 5, 2005)

Here is something to consider...do provider actions contribute to SD, PPH, etc? Are SD and PPH managed appropriated in the hospital? If your hospital based provider can't be trusted before the pushing phase then how can they be trusted when you come in for the most important part of your labor? If you can't be there when the stakes are so low then how can you feel ok rushing in when the stakes are highest? Do the interventions that take place during 2nd and 3rd stage really not matter as much? Do they have no effect on the likelihood of SD or "SD" and PPH, etc?

Just sayin'....my natural hospital birth ended in a baby born not breathing, being whisked away for resuscitation and massive PP bleeding that scared me and everyone else in the room. And it was ALL because of the way that my 2nd and 3rd stages were managed. I had zero interventions during the labor.


----------



## Kelly1101 (Oct 9, 2008)

I still think it's more about the state of the baby than anything that would happen during labor. I'd probably be okay not laboring at the hospital at all, but I'm not certain that my baby would not need medical help immediately after bith.


----------



## CherryBomb (Feb 13, 2005)

I don't "trust birth" or "trust" my body. Mother nature and my body don't give a shit if my baby or I live or die, and both have "failed" me multiple times, so sorry, I'm not going to "trust" either one. If other people want to, that's their business, but not "trusting birth" doesn't make me stupid, weak, or undeducated.


----------



## mambera (Sep 29, 2009)

Quote:


Originally Posted by *CherryBomb* 
I don't "trust birth" or "trust" my body. Mother nature and my body don't give a shit if my baby or I live or die

That is SO TRUE. Complications happen - in a significant proportion of completely intervention-free births. It's got nothing to do with 'trust.'


----------



## MJB (Nov 28, 2009)

Yeah, I'm a UCer and I'm not a fan of the "trust birth" catch phrase. I *know* that birth will go smoothly most of the time. I also *know* how to recognize problems and deal with them or *know* when to transfer. There's no trust involved there.
My first son was born in a hospital, and I got there 2-2.5 hours before he was born. He was monitored once or twice for 15 minutes, I didn't get a hep lock or IV, I wasn't deprived of food for hours on end. Continuous fetal monitoring is not evidence-based medicine (and is no longer common in natural births in the hospital), so why would that be a reason to think people who "don't trust birth" should head to the hospital in early labor? Most complications occur during or after the pushing stage. And of the ones that would occur earlier (like placental abruption/cord prolapse/etc) you would know to get your butt to the hospital.


----------



## SilverFish (Jan 14, 2010)

honestly, i don't think it's as complicated as some people are making it out to be. sometimes, especially for first time moms, it can be hard not to get overly excited about the start of labour. if you've never experienced it before, it's hard to know what is going to happen next. if your plan is to birth at a hospital, it makes good sense to let your labour get nicely established before going in. NOT just because the evil nurses and OBs will start pushing interventions, but because labour is an organic process that needs time and space to develop. the hospitals don't really want you there before you're ready either! it takes up valuable space and staff to deal with a bunch of 1-4cm dilated women...

anyway, "wait until you're pushing" is decent (if over-simplified) advice for first-timers, said to prevent over-eager/anxious women and partners from rushing in at the first twinge. until you're _actually_ close to pushing, you really have no idea that what came before was just small potatoes.

obviously, it wouldn't really apply to some of the more experienced mothers (or even birth-obsessed first timers) who might be more realistic about what they're feeling and how far along their labours really are.


----------



## accountclosed3 (Jun 13, 2006)

i think that is true, silverfish.

my first birth was really exciting.







from the moment i thought "ooh, this is it" i didn't know that i probably should have just tried to get comfortable and sleep for as long as i could.

i was so excited, i just wanted to feel and experience everything, that i stayed up to do that, and then meditated (and napped a bit) throughout the day, and by the time transition hit, i was like "i just want to go to bed." and guess what? you never "just go to bed" again. LOL

so, i think that for first time mother's it can be good advice to wait to go in. then, you are less likely to get sent home (which can be discouraging) or get put on a clock (which can lead to more interventions).

i think that trusting birth and trusting the body is really about trusting yourself. you can make great decisions for yourself if you just trust yourself. and that great decision includes the hospital, yk?


----------



## 2boyzmama (Jun 4, 2007)

I do it to avoid interventions. To avoid the fights over hospital policies. The reason I don't just birth at home is because I have a special needs son with a genetic condition. It was spontaneous, as far as the geneticists can determine (meaning neither myself nor my husband carry the genes that caused it) but our chances of recurrence are still higher than the general population. In my case, with my specific risk factors, the chances of something going wrong are right at or after birth, not during labor.

So I went to the hospital just before transition (because no one wants to be in the car during transition) and I labored in the parking lot, then the lobby. I did not go into the L&D room until I was nearly pushing.

For me it made the most sense. I was able to labor mostly the way I wanted to, in peace, with no IVs, monitors, etc. But I was at or in the hospital for the sake of my baby's health.

I trusted *my* body, because it had proven itself before and I believe in the design of a woman's body. But I did not believe in my *baby's* health, because we had specific risk factors.


----------



## Galatea (Jun 28, 2004)

When talking to FTMs, I don't say, "Wait until pushing." I say, "If you can still talk/laugh/do anything besides concentrate on the contractions, then it is likely too soon to go. Wait until you have to concentrate on labor and nothing else." This generally works for first-birthers. For my friend, she showed up at 9 cm and it worked. For my 2nd birth, following this rule led to a 40 minute car ride, standing up, at 10 cm, so I don't think it is great advice after the first birth. For my 3rd, we had a HB b/c I apparently can progress quickly!


----------



## CI Mama (Apr 8, 2010)

Quote:


Originally Posted by *zoebird* 
the other thing here is that listing out a group of possible reasons why people are choosing the hospital, and some of those reasons being "less than optimal" such as lack of trust in one's body or in birth, does not mean that every person who chooses a hospital birth will be choosing based on that reason in part or alone.

This is a good point. I want to add that trust or lack of trust in one's body are not polar opposite monolithic qualities.

I trust my body to do all kinds of things...to tell me when I'm hungry or tired, to dance with joy & abandon, to ride my bike to work & home every day, to sleep well when I get the chance, to see & smell & taste & hear, and all kinds of things. Through a long period of TTC I learned to trust that it would conceive a child (or to be OK if it never did), and I feel lucky that I did conceive. Through pregnancy I learned to trust my body to grow a baby, and through breastfeeding I've learned to trust that it can make food for my baby.

And there are things that I don't trust my body to do. I don't trust it to climb Mt. Everest or run a marathon or dance the lead part in Swan Lake. And I don't trust it to get something perfect the very first time that I try it, especially something as big and mysterious as childbirth.

I chose a hospital birth and in spite of my best efforts I had a c-section. I still trust my body. I think it's awesome that women can have swift, painless, unassisted births, I'm just not one of them. I also think it's great that women can scale Mt. Everest and run marathons and dance the lead part in Swan Lake. And I know I'm not one of them either.

I guess the point I'm trying to make is that trusting your body doesn't have to mean believing that it can or should do absolutely everything. Part of trust is knowing your own limits and respecting them.


----------



## Magali (Jun 8, 2007)

I'm choosing an arrive as late as possible hospital birth because I live 40 mins from a hospital and I guess I find some level of comfort in having emergency care available should I need it. Yes, I realize that an emergency can happen at any stage of labor, but I can't pick exactly how this birth is going to turn out, and I am just trying to do the best I can with what minimal options are available to me. So this is the balance I am planning on...go in late to avoid interventions, but still be somewhere that if I need help I can get it. This certainly doesn't mean that I think the hospital is the best place to have a baby...but in my situation, this is what feels right for me.


----------



## aylaanne (Mar 7, 2007)

nak

For my next birth, if I am living near the same hospital, I will likely go to the hospital either pushing or almost pushing. I'm a VBAC, which at most hospitals means continuous monitoring, which I want to avoid. I also don't want to deal again with the aftermath of a homebirth; my midwives and their apprentice, and my son's doula, all used my kitchen, and everything was out of sorts for days afterward. It might have been because we ended up transferring, but I still don't want to deal with it again.

And that's the real kicker for me. I've paid for two homebirths and had two transfers--that means I'm paying for my birth twice. I cannot afford to pay for another homebirth and another hospital admission. So, if I'm living near a natural-birth friendly hospital, especially if it's the same hospital where my first two children were born, I'm going to hire one of my midwives as a doula/monitrice, who can come, monitor my baby's heart rate during my labor, and check my cervix if that's something I want, and then come with me to the hospital when it's time to push the baby out.

If I'm not near a VBAC/Natural Birth-friendly hospital, then I may try another homebirth, but it really depends on the circumstances, and the midwives available in my area.


----------



## Adamsmama (Oct 24, 2003)

I'm wondering about this, too. I don't disagree with it at all -- I just haven't done it. With my first I was so excited to be in labor that I went to the hospital and got sent back home before actually starting active labor later that night. With my 2nd I waited at home for 3 hours of very steady contraction. They didn't get really really bad feeling for another 4.5 hours but by the time they did -- I had less than an hour until he was out. My 3rd was an induction but once I felt I couldn't take the pain anymore it was only an hour later that the baby was out (went from 5-10 and pushing baby out in hour both times).

So my question is, with baby 4, we live 30 minutes from the hospital my midwives/OBs deliver at -- there is a closer hospital, but it doesn't have as good a reputation and my practice doesn't go there, another one does. So -- what happens if I wait it out like I'm planning to -- if I wait too long I guess I have the chance of making it there 20 min before the birth -- 10-15 min before pushing. I'm afraid of having the baby in the car. I have very long early labor and prodominal labor but very short active labors -- I'm not sure if it is wise for me to wait.

Number 1 was a long labor with complications but number 2 and 3 followed the exact same pattern -- number 2 was 9 hours ... but took 8 hours to get to 5cm. With number 3 the labor was 7 hours with a 6 hour early labor.


----------



## dogretro (Jun 17, 2008)

I did not read all of the responses, so this is just my data point.

I REALLY wanted a UC, but dh was not comfortable w/ that. Baby number two was my first labor & vaginal delivery, so I understood. I did stay at home as long as possible. I made sure that we left before I got pushy & I walked in at a seven which was perfect.

FOR ME, once it was all said and done, I was very glad that I delivered in the hospital. Having never vaginally birthed before, I only had a mental idea of what would happen. I had NO idea it would truly hurt that badly. DD's heart rate also started to crash at the very very end (truly, down to 60) & it was v nice to have help & encouragement to push her out at the end. Plus, after she was out I was still in a lot of pain & was all shaky, etc etc.. Nothing that I was worried about b/c I knew it was normal, but it was v reassuring to be in the hospital with experts & not just me and dh. I would feel more confident in doing a UC now, but I told dh that IF I ever get pg again, I don't want a UC anymore.


----------



## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *Adamsmama* 
I'm wondering about this, too. I don't disagree with it at all -- I just haven't done it. With my first I was so excited to be in labor that I went to the hospital and got sent back home before actually starting active labor later that night. With my 2nd I waited at home for 3 hours of very steady contraction. They didn't get really really bad feeling for another 4.5 hours but by the time they did -- I had less than an hour until he was out. My 3rd was an induction but once I felt I couldn't take the pain anymore it was only an hour later that the baby was out (went from 5-10 and pushing baby out in hour both times).

So my question is, with baby 4, we live 30 minutes from the hospital my midwives/OBs deliver at -- there is a closer hospital, but it doesn't have as good a reputation and my practice doesn't go there, another one does. So -- what happens if I wait it out like I'm planning to -- if I wait too long I guess I have the chance of making it there 20 min before the birth -- 10-15 min before pushing. I'm afraid of having the baby in the car. I have very long early labor and prodominal labor but very short active labors -- I'm not sure if it is wise for me to wait.

Number 1 was a long labor with complications but number 2 and 3 followed the exact same pattern -- number 2 was 9 hours ... but took 8 hours to get to 5cm. With number 3 the labor was 7 hours with a 6 hour early labor.

What is the area like-- urban or pretty/rural? Possible to drive over there in early labor and then walk around for a while until things start getting serious?


----------



## Adamsmama (Oct 24, 2003)

Quote:


Originally Posted by *Kelly1101* 
What is the area like-- urban or pretty/rural? Possible to drive over there in early labor and then walk around for a while until things start getting serious?

City/suburbs ... we have to take the interstate to get the hospital -- if it is in the middle of the night or mid day we should be fine with time ... if it is early morning or rush hour it could take 45 min or more. Good idea about getting there early and hanging around. There is a big mall around there that we could use for walking if need be.


----------



## Quinalla (May 23, 2005)

Honestly, I don't think folks do recommend to literally show up pushing very often, only in circumstances where someone has been told C-section is their only option when is shouldn't be and the like. I think the more common advice is to show up to the hospital well into active labor, especially for first time moms who often have no clue when to go in.

I ended up going from 5cm in triage to complete as soon as I was checked (at my request as I felt my body starting to push) in the delivery room and I am pretty sure now that I was in transition for the car ride and check-in. I wouldn't recommend waiting as long as I did, but for me, things moved very fast and I don't think I felt the contractions until I was actually in active labor, so I didn't realize where I was in labor. It was pretty hilarious looking back at how frantic the nurses were to get the room ready after they figured out I was complete







Though they hadn't seen many painkiller-free births as they kept going on and on about how well I did.


----------



## Greenlea (Apr 21, 2010)

*What is UC??* I'm guessing something like an unassisted birth at home? Not sure but I can tell you why I feel that way, as I've considered both home birth (assited and unassisted) and I've had a hospital birth. I had no bad experiences with my hospital birth - including my midwife, nurses, and staff. I loved having my baby at the hospital - the nurses did everything for you, all cleanup, I could call down to get food and not have to make it myself, I didn't change my son once while in the hospital, I felt taken care of and well rested. And I did not have continuous monitoring of the baby, I didn't want it.

While I didn't go to the hospital ready to push, I did labor at home for a while with my son. But my shower quickly ran out of hot water and I was making a mess leaking amniotic fluid everywhere. At the hospital they had plenty of hot water and I didn't have to worry about the mess. But I still wanted a low intervention birth.


----------



## Paige CPM (Jun 28, 2004)

In regards to the statistical safety of going to the hospital later in labor and the whole idea that fetal monitoring is all it is cracked up to be (which I am sure many of you are well aware of)...

http://www.philly.com/philly/health_...-sections.html


----------



## veryhappydog (Jun 9, 2009)

Quote:


Originally Posted by *CI Mama* 
This is a good point. I want to add that trust or lack of trust in one's body are not polar opposite monolithic qualities.

I trust my body to do all kinds of things...to tell me when I'm hungry or tired, to dance with joy & abandon, to ride my bike to work & home every day, to sleep well when I get the chance, to see & smell & taste & hear, and all kinds of things. Through a long period of TTC I learned to trust that it would conceive a child (or to be OK if it never did), and I feel lucky that I did conceive. Through pregnancy I learned to trust my body to grow a baby, and through breastfeeding I've learned to trust that it can make food for my baby.

And there are things that I don't trust my body to do. I don't trust it to climb Mt. Everest or run a marathon or dance the lead part in Swan Lake. And I don't trust it to get something perfect the very first time that I try it, especially something as big and mysterious as childbirth.

I chose a hospital birth and in spite of my best efforts I had a c-section. I still trust my body. I think it's awesome that women can have swift, painless, unassisted births, I'm just not one of them. I also think it's great that women can scale Mt. Everest and run marathons and dance the lead part in Swan Lake. And I know I'm not one of them either.

I guess the point I'm trying to make is that trusting your body doesn't have to mean believing that it can or should do absolutely everything. Part of trust is knowing your own limits and respecting them.

This is one of my favorite posts I've read on here so far!

To further clarify, yes I'm interested in other women's choices because I'm curious about them, and we're on a public discussion forum, which is probably a good place to ask questions.

I keep reading birth stories describing a birth in which the baby couldn't descend well because of a short cord, or some other factor interfering with labor before the woman is complete. I know it's not literally "show up pushing", but I was curious as to what makes the risk of something happening during a longer active labor but before going to the hospital feel okay to you personally, but the risks of something happening after the birth seem greater than those during earlier labor.


----------



## accountclosed3 (Jun 13, 2006)

fwiw, i did have an unassisted birth at home and didn't make myself any food, or have to do anything but enjoy the process of labor and birth. after the birth, i didn't do any cleaning up either. i was supported, loved, and well cared for. so, it is possible to have a UC and experience those "hospital benefits" right there at home.

likewise, i did birth my first (and currently only) baby UC. i chose it for a variety of reasons--and i wouldn't necessarily say that trusting my body was one of them per se. it just seemed like the safest, and deeply right, method for us. that, of course, simplifies it, but it is true.









i believe that i can trust my body to run a marathon or climb mt everest if i prepare for it. preparing for it may be physical, mental, or spiritual. could be all of those things. and there is risk inherent.

i don't think i could do the lead in swan lake, not because my body isn't inherently capable, but because i do not have the requisite training.









but they are good examples of what we are willing to do and not willing to do, and how far we understand our own body's capacities. I think it's an important *very important* part of how, where, and with whom we choose to birth.

it requires us to have self-knowledge. that self knowledge will not lead astray. Choosing a hospital based on self knowledge is perfect. choosing a UC based on self knowledge is perfect. it's the foundation of good decision making, even with mountain climbing and marathons.


----------



## Kelly1101 (Oct 9, 2008)

Quote:


Originally Posted by *zoebird* 

i don't think i could do the lead in swan lake, not because my body isn't inherently capable, but because i do not have the requisite training.










You can't train your baby to be perfectly healthy.


----------



## CherryBomb (Feb 13, 2005)

Quote:


Originally Posted by *Kelly1101* 
You can't train your baby to be perfectly healthy.

Yes. A "low-risk" mom DOES NOT mean a low-risk baby. And even women who appear to be incredibly low-risk can have catastrophic complications come out of nowhere (yes, even during an intervention free hb or uc).

I don't believe you can train your body to have a perfect birth. You can do things to help improve your chances of a positive outcome, like exercising regularly so your body has stamina for birth, but there's just not a magic formula that guarantees you anything.

I don't agree that self-knowledge won't lead you astray. I've seen many times on this board womens intuition/self-knowledge blow up in their faces.


----------



## jeminijad (Mar 27, 2009)

Quote:


Originally Posted by *CherryBomb* 
I don't agree that self-knowledge won't lead you astray. I've seen many times on this board womens intuition/self-knowledge blow up in their faces.










You are right. Intuition is not infallible. In fact, I don't give it much credence as a diagnostic tool at all.

But getting to the hospital early (most hospitals, with most doctors & nurses) means you ARE going to be subjected to monitoring, poor positioning, restrictions on eating, increased risk of major abdominal surgery, and the usual laundry list that we are trying to avoid.

It is a trade off. No one ever argues that going in late, or homebirth, or UCing, is risk free. We are just trying to trade the nearly _guaranteed_ evils of the maternity machine for the possible evils of avoiding it.


----------



## Mountaingirl79 (Jul 12, 2008)

I labored at home until transition with my second birth for many reasons. The main one being that I didnt know how dialated I was and how close he was to coming until I got there. ( I was in labor for 22 hours at the hospital with my first, my second came in 4 hours, from start to finish. )

Also, I didnt want to be in the hospital any longer than I had to, because of my long hospital stay with baby # 1..and I wasnt quite ready for the home water birth I have planned for my next baby.

Anyway, I arrived at the hospital at 8 cms and he was born 30 minutes later. It was perfect for me at that time.


----------



## CherryBomb (Feb 13, 2005)

Quote:


Originally Posted by *Mountaingirl79* 
I labored at home until transition with my second birth for many reasons. The main one being that I didnt know how dialated I was and how close he was to coming until I got there. ( I was in labor for 22 hours at the hospital with my first, my second came in 4 hours, from start to finish. )

Also, I didnt want to be in the hospital any longer than I had to, because of my long hospital stay with baby # 1..and I wasnt quite ready for the home water birth I have planned for my next baby.

Anyway, I arrived at the hospital at 8 cms and he was born 30 minutes later. It was perfect for me at that time.









Absolutely! Though I like being in the hospital after birth, it's nice to have some quiet time with the new baby









But yeah, I don't want to get there too early in labor. With my vba2c, I had steady, regular contractions coming every 5-7 minutes for over 12 hours that petered out. Same thing the next day. It wasn't till the third day I went into full on labor. I was so glad I didn't go to the hospital that first day! As it was I showed up at 7cm, which was a little later than I would have liked, but it worked well


----------



## CI Mama (Apr 8, 2010)

Quote:


Originally Posted by *jeminijad* 
But getting to the hospital early (most hospitals, with most doctors & nurses) means you ARE going to be subjected to monitoring, poor positioning, restrictions on eating, increased risk of major abdominal surgery, and the usual laundry list that we are trying to avoid.

And if you know ahead of time that your hospital is one of the rare exceptions that does limit monitoring, allow you to labor in whatever position you want, eat whenever you want, etc., then obviously that's good information to consider when deciding when to show up.


----------



## Comtessa (Sep 16, 2008)

Quote:


Originally Posted by *zoebird* 
my first birth was really exciting.







from the moment i thought "ooh, this is it" i didn't know that i probably should have just tried to get comfortable and sleep for as long as i could.

i was so excited, i just wanted to feel and experience everything, that i stayed up to do that, and then meditated (and napped a bit) throughout the day, and by the time transition hit, i was like "i just want to go to bed." and guess what? you never "just go to bed" again.

This was me, too!!!
If I had been planning a hospital birth, I probably would have gone in about 12 hours into my labor, when my contractions started ramping up, assuming the baby was on her way out. It's a good thing I planned a home birth, because my labor was *52 hours* from start to finish and I _never_ would have avoided interventions in the hospital if I had been there for 2 days.

As it was, I transferred, so I actually did "show up pushing" - or, at least, fully dilated. I was too exhausted to push, so I went in to request an epidural to slow my labor (for once, that was a GOOD thing). I slept for 5 hours (yes... 5 hrs sleep at 10 cm... unbelievable...) and then pushed for *four hours* to get the poor child out. Besides that 11th-hour epidural, no other interventions... which was a miracle that I attribute fully to my home birth plans.


----------



## momtoafireteam (Aug 8, 2007)

I have employed a midwife to come to my home when I am laboring so that we go to the hospital as late as possible. She will do almost constant monitoring, we will be well aware of red flags etc. I had a very bad hosptial birth with my last baby and want to be at home for as long as its reasonable.

On the other hand, I have to be realistic. I have had multiple c/s's and all my placentas have always been over my incision site. My vaginal births have had very fast pushing phases. I trust my body to birth, but I dont trust my incision not to split open and have me and my baby dead before we are at the end of the road.


----------

