There are so many things that happen in the birth space (the hospital birthing space specifically) that no one talks about. So here I am, to just tell you what's up. As a reminder, not one word of this is to serve as a substitute for medical advice. Okay? Great. Read on, champ.
Hands in your V while pushing.
Yup, it's true. I cannot tell you how many births I have attended where the provider has fingers or hands inside someone's body (without their consent) while they are actively pushing their baby out. Some providers do this as a way to stretch the perineum and vaginal walls or as a way to help you know where to push. (PS. there are other methods that can be used to help you know where to push aside from fingers or hands inside of your body). I have also seen providers put soap into the vagina or on the baby's head as it is crowning to make it more "lubricated" and to prevent friction. If you would prefer that this did NOT happen to you, you will need to discuss this in advance with your provider(s) and ensure that your doula and/or support partner are aware of your wishes. You can also say no while you are in labor, although it is difficult to predict how your brain will be functioning while you are in active labor. Don't wait, address it.
Continuous or "mobile" monitoring.
When you arrive in triage, one of the first things a nurse will likely do is hook you up to a continuous monitor. These monitors have straps that go around your body with the round monitor attached to it to read your contraction pattern and baby's heart rate. A great resource to learn more about the evidence on using continuous monitoring during labor can be found at Evidence-Based Birth. One of the things that I have seen become tedious and frustrating for birthing people is that sometimes when you move while on the monitor, baby's heart rate can be "lost", or the monitor becomes loose and needs to be adjusted. Within a minute or less, you'll have someone in your room to reposition the monitor, tugging and pulling and tightening where you may not want to be touched. There are various types of monitors that can be used. Learn more by researching fetal scalp electrodes (FSE), mobile monitors and intermittent auscultation.
Umbilical cord pulling (traction).
In my experience, most providers actively manage that last stage of labor by pulling on the umbilical cord and trying to yank your placenta out. This can happen within just a couple of minutes of you pushing your baby out even if you are not showing signs of a postpartum hemorrhage. YOU have a choice with how the third stage of labor is managed (or not) and it's important that you address it beforehand. Learn more about the third stage of labor here. If you have a support partner or a doula, they can remind the room how you would like things to go down (pending there is no medical emergency) so there is no grey area. There are also things you can do to encourage your placenta to detach naturally such as nursing your baby (nipple stim if baby is unavailable), skin to skin, changing positions, or simply giving it time. A couple of questions you can ask prenatally:
How do you typically manage the third stage of labor?
What is the hospital policy regarding the timeframe for the third stage of labor?
At what point do you believe Pitocin or other interventions may be necessary during the third stage?
There more where this came from, my friends. Ask the important questions and don't stop until you are satisfied with the answer. If you aren't liking the answers you are receiving or feel you're being manipulated into believing something that doesn't sit right, you can find someone else to tend to your care. Decisions should be SHARED and informed, don't settle for anything less.
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