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The Hospital “Birth Plan”

There is a fairly normal course of events for women giving birth in a hospital setting. In order to be truly prepared to give birth in the hospital, it is important to be aware of today’s standard hospital procedures. All hospital procedures and interventions can be refused under your right to informed consent, but doing so requires knowledge, strength and attentiveness. I hope the following list of things you may encounter in the birthing room will encourage you to talk with your medical care provider in advance about hospital routines and your own personal choices, as well as help prevent unpleasant surprises during your baby’s birth.

This list has been modified from content in Woman-Centered Pregnancy and Birth. These points might not necessarily reflect how your own hospital operates; that’s something for you to investigate and discuss with your medical care provider.

The following are typical, routine procedures encountered in hospital births. If you are made aware of their standard protocols, you’ll be better prepared to deal with them if and when they arise:

  • To have at least some separation from the person who brought you to the hospital due to filling out admission paperwork, parking the car, providing a urine sample, being examined in triage, etc.

  • To be told to remove all your clothing and put on a hospital gown.

  • To have staff talk over you, rather than to you, and to have many different people walk into your room whenever they want without your permission and without introducing themselves.

  • To have your cervix examined by a nurse upon admission and approximately every hour thereafter. If you allow it, you may have multiple vaginal exams per hour by more than one person.

  • To have an IV or a saline lock inserted into your arm.

  • To be denied food and drink until the birth. (At best, expect clear liquids or ice.)

  • To be asked to give a urine sample and perhaps a blood sample.

  • To have an ID bracelet attached to your wrist.

  • To have to sign a consent form that states your doctor will be responsible for making the decisions about your care—rather than you.

  • To have a fetal heart rate monitor attached around your belly—two round discs on straps that will often stay with you continuously until you give birth (or, at best, for 15 minutes out of each hour of your labor).

  • To have your water manually broken at about 4 centimeters. Afterward, they might go a step further and screw an electrode into your baby’s scalp to measure the heartbeat and place a tube in your uterus to measure your contractions.

  • To be offered pain medications repeatedly, even if you have stated you do not want them.

  • To be offered Pitocin at some point during your labor “to speed things up.”

  • To be told you must remain in your bed through most of your labor, especially when pushing.

  • To either have your legs put in stirrups or held at a 90 degree angle at the hips.

  • To be told when to push, and perhaps even told you are not pushing correctly.

  • To be given an episiotomy if someone else determines that your perineum will not stretch.

  • To have the cord clamped and cut before it finishes pulsating.

  • To have your baby suctioned repeatedly.

  • To be given a shot of Pitocin to make your uterus contract and deliver the placenta.

  • To not be asked if you want to see the placenta.

  • To hold your baby on your chest for a few minutes, before it is taken away to be dried, weighed, warmed by a machine and checked over.

  • To have antibiotic eye ointment put into your baby’s eyes without first being asked permission.

  • To have your baby receive a vitamin K injection without first being asked permission.

  • To have your baby receive the Hep B vaccine without first being asked permission.