Welcome to another episode of Your Birth Bestie podcast! Thank you so much for being here today. I am very excited to bring this episode to you and reveal some of the things I have seen over the years, because over and over again, it seems to be a pattern of maternal care where these huge gaps of education are completely missing. Expecting parents are just not aware of their options, simply because they are not discussed in prenatal visits with their doctor!

And this is why taking a birth course, specifically one for how to have a positive hospital birth experience is so important, not the one your hospital provides though, you need an outside perspective on your real choices and the truth about the power you really do have in your own birth. It’s not just about what to expect at that particular hospital or for how they frame labor and birth to be, even if it’s well intentioned... I just think there is a lot of bias there and seeking another resource I’ve found to be very helpful for moms.

So that’s why I will be sharing with you, things doctor’s won’t tell you during pregnancy to have the best birth experience. You deserve this info, you need this info, and I would love to talk to you more about any of these things, so you can approach your hospital birth experience with confidence and autonomy.

Before we start, I want to just say to anyone who is pregnant as you are listening to this, I understand your fears and concerns, because I’ve been there and I get the same questions all of the time, so want to help support all of those worries and eliliminate any fears that you have. 

But I also want you to know that together, we can uncover the truth that often get overlooked in hospital births, giving you the tools to make informed decisions and ensuring your voice is heard. So before you go at the end of this episode, be sure to download my best free resource yet. If you’ve liked all my other free downloads, you’re going to love this and I’m so glad to share it with you, but it’s called ‘15 Hidden Hospital Birth Choices Every Pregnant Mom Should Know: From Your First Appointment To Your Last’. You can find it at bethconnors.com/choices and download that document to uncover some of the choices you probably never knew you had, get out of the what am I “allowed” to do mindset, and take control of your birth today! 

So, let's get started with the things doctor’s won’t tell you during pregnancy to have the best birth experience. Right out of the gate here I’m going to call out inductions. And the overuse of them first and foremost. The rise of inductions is absolutely mindblowing from only 9.5% of pregnant moms being induced in 1990, and today it is 33% which comes down to 1 in 3 moms are getting induced. It’s not uncommon for hospitals to suggest inductions for convenience at 39 weeks or really after that whenever mom is ready, meaning when mom is too excite or anxious or just can’t wait to meet her baby, yes those last few days and weeks are so long so this is so freaking tempting… or even as a “soft call” if something is concerning. There may be alternatives of expectant management before always jumping to immediate delivery with induction. 

Of course it would be great for everyone’s schedule and planning purposes if we would know when labor would happen, for how long, and exactly how it would play out, but that just isn’t the case and we have to be okay with that. As providers, we got into this work for a reason, and we have to accept the unpredictability of this work. Overusing inductions is not okay and not fully informing patients on the risks of induction is not okay either. Inductions of course come with risks as well and the key here is as a patient, you need to discuss your options with your healthcare provider and start that conversation if they don’t. Don't hesitate to ask questions, express your concerns, and consider the necessity of induction.

You have the right to decline an induction at any point if you’re not comfortable with that option. As long as you’re informed and willing to accept the risks presented, and then after considering you still instinctively feel it is the best choice to postpone medical induction, then that is great and I support that.

With full transparency, I had elective inductions with both of my hospital births. My first pregnancy I didn’t know I was consenting to an elective induction by going to L&D from my clinic appointment when I was found to be 6 cm dilated on a cervical exam randomly in the office with no other signs of labor. I should have absolutely went home, but I wasn’t given that choice. I was rushed over to L&D without a thought and just complied to whatever was happening. I didn’t even feel one contraction at that point, but just rolled with it. Looking back that is so disappointing that this was my support team!

And then with my second, I was also about 7 cm dilated without labor signs at a clinic visit and offered an induction. I went home for a few hours after that appointment and made the decision to get admitted for an induction where they just broke my bag of water and I had a baby, but it was something I choose and I felt comfortable with the risks.

Since then, those two experiences were absolutely learning experiences and even though the first birth was traumatic for me and thankfully the second birth was such an amazing experience, I would have done both differently and not even had the cervical exam in the first place to know I was so far dilated, to even tempt me to be induced for advanced dilation. I have so much more trust now even just a year and a half later from my continuing education this past year and I wish I could just shake my previous self and be like why are you doing this? Why is your provider wanting to do cervical exams and membrane sweeps and breaking the bag of water to speed things along. It all seemed fine at the time, but I too should have questioned “why” I was doing these things. Ultimately, what it was, was just being impatient and not having the support and confidence to wait. It’s as simple as that.

Please just remember, it's your body, your baby, your birth. You have the right to be informed and make decisions that are best for you and your babt. Hopefully with me learning things later on, you will take these lessons in this episode and apply them how you see fit to have the best birth experience that you can, and eliminate some of the stressful situations I was put through.

Going off this too, in terms of trying to schedule and control birth, is understanding hospital routines versus individual needs. What your doctor won’t tell you is that hospitals have routines, policies and procedures, but often, those routines may prioritize efficiency or staffing issues, over your individual needs. Continuous fetal monitoring, artificial rupture of membranes (AROM), and strict timelines are all part of the hospital protocol. But remember, you can advocate for what's best for you. Your comfort and preferences do matter.

Nothing makes me more angry than hearing stories of moms being rushed in labor and their labor augmented, which means sped along, the moment they get to the hospital. The textbook definitiion of an adequate contraction pattern to help your cervix dilate and progress labor is strong contractions every 2-3 minutes apart, lasting for 1 minute each. If you go into the hospital in early labor and are admitted, this is the standard you are often held to. And then if you don’t make cervical change every few hours as they’re constantly checking you and your contractions aren’t that ideal pattern, you bet Pitocin is the first thing just automatically added without question. Or breaking your bag of water. Basically just artificial interventions to make things happen faster. Faster is not better. Not for your at least… The speed at which you birth your baby is individualized and the hospital routines should reflect that. But they absolutely do not. So definitely learn about what hospital routines may affect your labor and how you’d handle certain situations. And make those plans way before labor even starts so you’re ready to fully advocate for yourself. 

Also, consider ways to support minimizing the time that you’re “on the clock” at the hospital by considering staying home during early labor. Your provider won’t always give you this option unless you specifically ask about it, because again it’s about convenience. It’s often beneficial though to stay at home during early labor, so knowing when it’s the right time to head to the hospital is improtant becasue arriving too early can definitely lead to unnecessary interventions. Ultimately, I would love for you to trust your instincts, and don't rush birth. Early labor can be a beautiful and intimate time for you and your partner, so why not enjoy it if you can.

Pain management options are another part of childbirth prep that are neglected, especially when planning a hospital birth and your provider will likely not talk about your options for this. They might ask you if you want an epidural or not, but there is usually no conversation about the many other ways you can manage labor without medication if that’s something you’re interested in. What I’ve noticed is that hospitals often focus on epidurals as the main pain management option and some providers even encourage them. Because it’s definitely true that a laboring mom who doesn’t feel a single contraction, is happily lying on her back in the bed, cooperative to exactly how the provider wants things to play out at delivery, is a pleasant thought right? But at what risk… Not only is this fantasy land not what is guaranteed to happen with an epidural, there are also risks to getting an epidural and potential disappointments from mom if she wasn’t supported to have the unmedicated birth she wanted. 

Knowing how comfortable your provider is at supporting physiologic birth is good to know as well as all of the amazing other alternatives to consider for pain management. It is really about mindset, planning for what coping techniques will work best for you, and then practicing for the real deal. It’s absolutely worth it though.

I’ve worked with many moms who wanted an unmedicated birth but didn’t think they were going to be able to handle the pain of birth based on what they’ve heard in their life and how terrible it was or that they have a low pain tolerance, but then when they uncover alternatives and how many options there are to coping with labor pain and breaking down how to breathe through a contraction and feel supported during labor, it’s not so scary. It was much more in their control than they ever thought it could be, and they surprised themselves and went on to have unmedicated hospital birhts. Women absolutley find relief in alternative pain coping methods and epidurals aren’t the only way. If you are planning for an epidural, that’s great too it is really ultimately whatever you want, and you should feel supported in that choice, not forced into a decision that is ultimately based on your provider’s comfort. Remember, you have choices, and exploring these options can empower you to create a positive birth experience.

Another option during birth that you absolutely have, even though time and time again, and it happened to me in my first birth, is that I was “helped” or basically forced onto my back when I was 10 cm dilated to begin pushing, but you have the option to choose what position you want to deliver your baby in. Many providers favor bed-bound positions, specifically lying on your back with your feet in stirrups or one person on each side holding your leg back. I remember when I was pushing for 4 hours on my back with my first baby, without any position changes even though I just wanted to be on my hands and knees leaning over the head of the bed, I had so much hip pain after in addition to all the postpartum stuff going on. It was the forced pushing on my back when I was told I was 10cm dilated andn the yelling and counting to keep pushing and yanking my legs back. It was awful looking back, but I thought that was normal at the time because I didn’t know better.

This brings up a good point too that the time in which you begin pushing is another important part to consider and know about ahead of time. Just because your hospital provider may encourage immediate pushing, it’s absolutely okay to wait fo the natural urge to push and I actually recommend it. It really is amazing when you can pause for a second and let your body guide you and trust the instincts that will help you hopefully bring your baby to you wish ease. I will never know if this would have been beneficial for me, but I’d have to imagine that starting to push at 10 cm dilated without any luck for 4 hours and then reaching a point that they needed to intervene they said and do a c-section or vacuum because 4 hours was the limit, would I have had a shorter pushing time if I would have waited for the natural urge to push? Probably right! I’d like to think so and it’s unfortunate that I went through this and so many other moms do too.

So now please, I hope you know better from hearing my experience and that now as a midwife this would never ever be something I would have a patient do. Even with an epidural, you can be in different positions as you are pushing and should be encouraged to do what feels best for you. You have the right to request alternative positions like squatting, kneeling, or using a birthing stool. You also can push lying on your side in the bed if you have an epidural and I encourage you to have an idea of what sounds like it would work for you and know you have a choice when the time comes.

It was so strange to me too when I was working in the hospital, that OBs always did what we called “broke down the labor bed” when mom was pushing for easier maneuvers during delivery. It gave them more control really. And midwives never ever broke down the bed. It wasn’t hard at all to have a mom deliver with the foot of the bed attached, it was less intrusive to mom too. Because really what happens is the nurse calls the doctor in when baby is just about to be born usually, and the chaos unfolds where the bed is taken apart the bright lights in the room are turned on directly at the vaginal area for better visualization, also something I never did for deliveries as a midwife. And then the baby warmer is turned on and makes a bunch of noise and more people are called to the room, it’s a whole deal! 

And I’m going off on a tangent now unrelated to labor positions, but just in general the environment of the room and how your birth unfolds should be up to you. I would absolutely include in your birth plan how you invision your birth, down to who is allowed in your room, what you want it to look like, feel like, sound like, smell like, all of those things are really important too. But in regards to positioning, your body knows how to give birth and adapt to your baby’s movements as they are also trying to find their way out, and finding a position that feels right for you can make all the difference. Don't be afraid to let your preferences be heard. 

This is just as important too with questioning certain policies or standard routines in the hospital setting also. You’ve probably heard someone say “I wasn’t allowed to eat or drink during labor.” I bet we all have right? But this is so not true! 

I’ve actually heard many midwives agree this is not best practice and they don’t agree, but it’s the hospital that they work for that has this policy, so they have to recommend this as well. But, just because this may be the case for you too in the hospital and this is the recommendation, doesn’t mean you have to follow it. It’s important to discuss this with your healthcare provider to understand where they are coming from and explore options to make sure based on your own situation you are adequately nourished during your intense journey of childbirth, and able to eat light snacks and drink water or an electrolyte drink for sure. It just truly doesn’t make sense to me how women are starved for days when it is not evidence-based. 

The last thing I wanted to mention and I get just as equally frustrated as when I mentioned rushing labor like I talked about before, but is the use of Pitocin routinely after delivery. And I’m talking immediately after delivery I’m making up this number, but based on my experience I’d say 9 out of 10 moms don’t know whether or not they received pitocin in that immediate postpartum phase. It is just part of the hospital medical system that nurses routinely hang the IV medication on the IV pump and its started at delivery and then increased when the placenta is delivered to help the uterus contract down in hopes of reducing bleeding. But even though that is the active management recommendation in medicine for every mom, mom’s still need to have this choice and know this is happening. It’s their right to consent to everything that is happening and to know the reason they are receiving Pitocin after delivery and choose for themselves if that is something they are interested in. Yet, most moms have no idea! 

What I made sure to do as a labor and delivery nurse, was always prepping parents ahead of time for a few steps ahead in the birth process if they didn’t take a childbirth course or do preparation ahead of time. Pitocin education absolutely was part of this every single time! It amazes me how all patients aren’t given this same level of education when their in the hospital because I want you to have all the information you want and need to have the best possible birth!

Thank you so much for listening to today’s episode of Your Birth Bestie podcast! I hope this was helpful and maybe even thought provoking going into your upcoming prenatal appointments considering what you are interested learning more about and advocating for your wishes.

If you are expecting your little one at the end of this year or early next year, I want to invite you to join the waitlist for my newest program coming out on November 8th. It is called Your Birth Bestie 1:1 Virtual Support Through Pregnancy, Birth, and Postpartum. I will only be taking a few clients, so be sure to sign up for the waitlist to get first dibs and access to special bonuses. This will be a fully comprehensive, personalized support package for you as you are navigating this journey and also includes live virtual birth support when you go into labor and I’m so excited to support you in this way. Head over to bethconnors.com/waitlist and sign up! I am looking forward to meeting you. Until then, remember you have the power to make informed decisions, stand up for yourself, and create a positive hospital birth experience. Thank you so much for joining me and I will see you next Tuesday. Bye guys!