Wednesday, May 6, 2015

DRMC Unveils 'Simply Birth Suite' for Low Risk Mothers

Last week Dixie Regional Medical Center unveiled it's new 'Simply Birth Suite' for "no to low risk women". Women in the community have been excited about this new option, but there seems to be several misconceptions that I'd like to make people aware of.

First, the 'Simply Birth Suite", is a mere addition of two beautiful rooms inside of the hospital. Yes, they are stunning. Gone is the small, uncomfortable, adjustable bed and replaced with a queen sized bed. The rooms are large, and offer a beautiful tub in which you can labor. You may or may not notice the absence of the infant warmer, and may notice the addition of comfortable chairs and a more inviting atmosphere than the regular rooms.

But what are the medical differences from the regular rooms, and the similarities to home birth? Not much, I'm afraid.

You may decline to have an IV. You do not need to be continually monitored, beyond an initial 20 minute monitoring session when you are first admitted. You will be monitored via intermittent doppler. You may use different pushing positions, based on the discretion of your care provider. Baby will be with you, rather than taken to a warmer.

But that's really where the differences end.

You will need to submit an application. Your past and current medical history will be reviewed before you are either accepted or rejected. You are required to take a hypnobirthing class if you have not given birth without medication before. You are required to have dedicated support for your whole stay. You are still in the hospital, which has policies and procedures that must be followed if any (even minor) blip comes up. You will not be admitted to stay until you are at least 5cm (which is not a bad thing - just be aware). You will be unable to use one of the two rooms if they are full when you go into labor.

You are still not allowed to birth in the water.

Did I also mention that it's the same doctors and nurses who will be attending you? This seems to be the biggest confusion. Women have asked me if I will now be able to attend at the hospital. The answer is no. It is the same doctors and the same midwife (Katie Gubler - whom I have heard is fabulous!) who will be attending women, and the same nurses.

Women planning a VBAC are not allowed to utilize the birth suite rooms, even though they are inside of the hospital. Statistically, there is a 0.3-0.7% risk of uterine rupture with a vaginal birth after one prior cesarean, and less than 2% for up to four prior cesareans. This is less than the risk of cord prolapse and the need for immediate cesarean in any other woman. But, women planning a VBAC are not allowed.

I am awaiting news on how the actual delivery process goes. At DRMC, the routine protocol is lithotomy (on back/mostly reclined, knees pulled back) and directed pushing during each contraction while the nurse sweeps in and stretches the inside of the vaginal opening (which is unnecessary and often causes swelling). Does this still occur within the 'birthing suite' rooms? Is the newborn exam done on the bed with mom? Is mom allowed to really EAT while in labor, and not just ice or jello? I'm unsure. I will update if I ever learn the answers to these questions.

While these are wonderful steps taken by DRMC to offer women an additional option, it is not "just like home birth" as claimed. Especially when those who attend you have very likely never attended a home birth before. I would be curious to know how many have even witnessed a truly  (and purposeful) physiological birth without any interference during, or after. Obstetricians are trained surgeons who follow their own and the hospital's set of guidelines and protocols ... and we know from ACOG's own admission that only 1/3 of current obstetric protocol is based on empirical evidence.

Ask in depth questions before making a decision about where to birth - whether hospital or home. Ask what kind of philosophy your potential care provider has regarding birth. Is it normal? Natural? An emergency waiting to happen? Do they facilitate physiologic birth? Do they encourage autonomy and choice for the birthing mother? Do they follow evidence-based protocols? Are they up-to-date with research?

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