Tuesday, March 20, 2007

Blogger's Hospital Won't Allow Birthing Balls

Katie Allison Granju, Knoxville blogger and author of Attachment Parenting, is scoping out locations for her upcoming birth. Katie has specific concerns due to a genetic condition, but also has certain criteria for how she'd like to labor, and has hit several barriers in finding what she needs, as described in this post. Katie would like to labor in water, but the hospital only has two rooms with tubs. She suggested renting one and bringing it in, but was told by the head of nursing that they only allow women to labor in water "if their water hasn't broken and they aren't dilated." In other words, they don't allow women to labor in water. Why a healthcare professional who presumably knows what labor is would tell a woman that she can labor in water if her water hadn't broken and she isn't dilated is beyond me. Nurse Cranky took things one step further, telling her she can't use a birthing ball because she might fall off, and it's a liability issue. Katie also describes the hospital's "support" for women who don't want epidurals - "support" to them apparently means "we won't push drugs on you," but doesn't seem to include any techniques or strategies for helping laboring women otherwise cope with pain.

I did a medical literature search yesterday to try to find instances of birthing ball injuries or descriptions of liability concerns, but found no such evidence. This doesn't mean it has never happened, but it obviously isn't being discussed much in medical publications. Most of these balls, also used for physical therapy and exercise, are pretty sturdy, and are built with sitting, bending, and stretching on them in mind. They're also low to the ground and flexible, so a fall off of a birthing ball would likely be less dramatic than falling off of a bed, chair, or toilet. One commentary from The Practising Midwife, The Risk-Managed Birth Ball," mentions another U.S. hospital that didn't allow birth balls, because "they haven't been risk-assessed," and makes the point, "Instead of simply risk-managing the things that might help women in labour, surely what we really need to address is the culture of fear and litigation which has somehow enshrouded pregnancy and birth, and the ways in which we can break this down, for the sake of everybody concerned."

Kudos to Katie for pushing the issue and standing up against silliness. The dismissive attitude of the hospital staff tells me we have a way to go before the concerns of laboring women are taken seriously.

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Blogger Hilary said...

The very definition of true labor (as opposed to false labor) is progressive dilation. Do those tubs get used at all?

Based on my experience as a doula, these policies get really flexible depending on who your nurse is and who your doctor is. If the doctor, who is not usually a hospital employee, is OK with options that are supposedly "against hospital procedure" (such as not having a constant IV, no eating, etc.) and the nurse isn't a control-freak, sometimes things can slide.

That being said, I have witnessed a minor birth ball incident, but this was one in a plastic frame on wheels. Nothing serious, but a little freaky. I recommend a plain old ball with no wheeled frame.

1:56 PM  
Blogger Rachel said...

Thanks, Hilary - I really appreciate your comments and doula's perspective. It would be nice if the hospitals would make the policies more friendly up front, rather than making women depend on exceptions. I suppose it limits their liability to be able to say, "That wasn't supposed to be there." Plastic frame on wheels? That sounds too complicated to me. :)

2:39 PM  
Blogger katie allison granju said...

The main problem with most hospitals' birth policies is that they are not evidence-based.

EXAMPLE: Water is a great birth pain relief tool. It also has no safety risks for healthy women having uncomplicated labors. Yet I was told by this nurse that it was "unsafe" for woman to be in a birthing tub after they are dilated or after their water breaks. She made this statement (and the hospital made the policy) based on no evidence. Theyjust happen to think this. If they reviewed the medical literature, their position would clearly be seen as absurd.

4:57 PM  
Anonymous Jackson said...

Nashville seems particularly bad. With our first son we were in Washington, DC. Sabrina could have labored any way she chose. we wrote up a birth plan and it was respected and observed by the midwives and the hospital.

Kids 2-4 were delivered in Nashville with progressively restrictive options and care. When there were midwives in the North Tower of Baptist the options seems reasonable. Then St Thomas bought Baptist and that all seemed to change.

12:54 PM  
Blogger Rachel said...

I'm glad Sabrina's first experience was so accomodating. I wonder if it was the difference in locale, or that hospitals seem to be becoming more focused on liability and less focused on women and babies as time goes by?

12:56 PM  
Blogger Loonytick Skook said...

Interesting. My cousin gave birth in Maryland, just outside the DC area, and the nurses told her they'd never had a natural birth there. Can you imagine? Forget birthing balls and pools, they were flabbergasted that she refused an epidural!

I have found Centennial to be a much more mom-friendly birthplace than Baptist. I labored there in a whirlpool at their encouragement (although water birth wasn't something I considered and don't know if it was available) and also used a birthing ball (although I found it to be spectacularly unhelpuful, despite how wonderful it felt to sit on one of those balls in the last months of pregnancy), again at their suggestion.

After my experiences there and what I've witnessed of friends' experiences at Baptist, I just don't get how Baptist earned it's reputation as the place to have babies.

10:50 PM  
Blogger Crunchy Hippie Mom said...

I had my daughter at Harrisburg Hospital in Harrisburg PA. I have to say they were extremely ok with any unconventual ideas we wanted to try. They have birthing baths in each room, they allowed me to bring in my own exercise ball, I was encouraged to labor at home by my midwife, who also was allow to deliver my daughter and they actually encouraged me to wait it out if I wanted to and not get an epidural. I ended up having a less then natural birth, I did end up getting an epidural which prevented me from giving birth in the position I wanted to, but I felt I needed such relief after 24 hours of labor in order to keep going. My tip would be for anyone who wanted a less then typical birth in a hospital to bring a doula or friend who has given birth unaided with them. My sister came with me when I had my daughter and she was awesome about making sure I got everything I wanted, she knew what questions to ask the nurses and kept everything under control.

8:59 PM  

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