1) The use of continuous Electronic Fetal Monitoring (EFM). I wrote about this one last week. This chains mom to the bed. She's not moving around, helping her baby figure his/her way out. This policy is applied in nearly all hospital births. It's very convenient for the nurses, but not for the mom. Evidence indicates that it is not safer for the baby and the c-section rates rise when EFM is used. Check with your hospital and your care provider. If your care provider "approves" intermittent monitoring, make sure that gets written in your chart. (Just a heads up -- while this improves your chances of not having EFM, it is not a guarantee.)
2) If your water breaks, you are in bed for the duration of your labor. They claim this is for your benefit, saving you from a c-section, as the umbilical cord could suddenly slip out, endangering the baby, making a c-section necessary. The chances of this actually occurring are about .3% of all births. How can you prevent this from occurring? Don't let anyone break your water! This is more likely to happen if the baby is high in the pelvis. If your baby is low, this is not really a risk. Also, if this is going to occur, it usually happens when the water breaks.
A couple other things worth noting that may or may not seem obvious: You will be on a time clock once your water breaks (find out what that means at your place of birth - usually 12-24 hours), so you really want to do things that encourage the baby to come. Laying in bed on a monitor doesn't really do that! Pitocin is usually started after water breaks. Evidence just doesn't make a lot of sense with this policy. They say that they are trying to prevent you from having a c-section, but by keeping you in bed, that is exactly where you are headed!
3) Vaginal Exams every two hours. The reason women are given vaginal exams are because they have epidurals and can't feel when they are ready to push. A woman who isn't numb doesn't need to be told how dilated she is or when to push. Failure to Progress is the 2nd most common reason women have c-sections (2nd to already having had a previous c-section). So let's add this up: She's in bed, on a fetal monitor, having vaginal exams every two hours. She's not moving or using gravity. I know of a hospital midwifery group that hardly ever does vaginal exams, unless there is a medical reason to do so. This is how it should be. Many women will stay at a certain number of dilation for many hours and then suddenly dilate in a short amount of time. Labor is not all about the dilation of the cervix! Vaginal exams are directly related to the dreaded time clock.
4) Does your hospital employ midwives? This is a big deal. If there are not midwives at your hospital, only the medical model of care is practiced. This is the only model the OBs use and the only model the nurses see. The midwifery model of care views labor and birth as a normal process. The medical model views childbirth as a medical emergency waiting to happen. They believe that medicine and technology improve the safety and process of birth.
5) Does your hospital have a no-VBAC policy? Then they don't trust birth and they don't read the evidence.
Finally, don't ignore the red flags. I could go on and on about policies that the majority of hospitals have that are problems for a natural birth mama. Follow your gut. There are great places to have your baby. Seek them out. Hopefully this list will be helpful on your journey. Don't be a victim! Like I always say, as long as your baby is still inside, you have options. This is your birth. Choose a birth place that respects your wishes and shows reverence towards your special day.
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