Health Matters: Six things you (probably) didn’t expect when expecting
In the U.S., more than 98% of childbirths happen in hospitals; just less than 1% occur at home, and 0.5% in birth centers. Childbirth is the most common reason American women are hospitalized. Moms and newborns account for a quarter of all hospital discharges. What should you expect when coming to a hospital to give birth? Here are some aspects you may find surprising:
1. Your experience can drastically differ depending on the hospital
Hospitals vary in location, size and services provided. The American College of Obstetricians and Gynecologists divide hospitals into four tiers, from the Level 1 community hospital with basic care to the Level 4 regional perinatal center. The higher-level hospitals have specialists such as anesthesiologists and neonatologists available around the clock. Choice of hospitals can change your likelihood of getting a C-section or being allowed to attempt vaginal birth after a previous C-section. If you’ve had a challenging pregnancy, coordinate with your obstetrician to seek out a higher-level facility early on.
2. Your obstetrician may not be the one who delivers your baby
Obstetrics is one of the most demanding medical specialties because babies can come anytime. Most obstetricians practice in groups where several doctors share the call burden. Unless you are scheduled for a C-section or induction of labor, you’ll be under the care of whoever is on-call that day, and it may not be whom you’ve been seeing for the past nine months.
3. Your birth plan doesn’t really matter
You may have a birth plan, but it has little impact on your childbirth experience at a hospital. First, preferences for a delayed clamping of the umbilical cord, skin-to-skin contact with the baby, and lowering the drapes to see the baby emerge during a C-section, are already standard practice. Second, some of the things, such as a water birth tub, may not be available. Third, for important decision points, the staff will ask you – type of pain control, breastfeed or formula, circumcision for your baby boy. Lastly, all plans go out of the window if the safety of the mother or baby is in jeopardy. You may have wanted a natural vaginal birth but could end up needing extraction or an emergency C-section. Making a birth plan is a helpful exercise for parents-to-be, but don't get too attached to it.
4. Lots of people are on your care team
When it’s time to push and birth is imminent, your hospital room fills with people – nurses for you and the baby, the obstetrician or midwife and their assistants, possibly residents and students. God forbid, if you run into trouble like shoulder dystocia, retained placenta, or bleeding, then more people will show up. For C-sections, you’ll also have anesthesiologists, scrub nurses, surgical techs, and neonatologists. After birth, add on pediatricians and lactation consultants. It truly takes a village to give birth to a child.
5. There are many choices for pain control
Labor pain can be intense. For first-time moms, know that it gets better with subsequent births. Pain perception is highly individualized so only you know what you feel, what’s tolerable and what pain control works for you. The hospital provides a variety of options, from natural methods such as coached breathing, to medications including IV opioids, nitrous oxide (i.e., laughing gas) and epidural or spinal anesthesia. Two-thirds of American moms choose epidural, which is the most effective. An epidural does not slow down the progression of labor or diminish your ability to push. You can request an epidural at any point during labor, but you must stay in bed with a urinary catheter afterward because you won’t be able to walk or urinate on your own.
6. Risks of pregnancy don’t end with delivery
Some complications of pregnancy, for example, bleeding, amniotic fluid embolism, eclampsia and cardiomyopathy, may not manifest until hours or weeks after birth. Hormonal and other bodily changes associated with pregnancy take time to resolve, placing the new mom at persistent risk for blood clots, heart attack, stroke and depression. You’ll be monitored closely while in the hospital. Stay vigilant after you leave and communicate with your doctors immediately if you feel something is wrong.
Qing Yang and Kevin Parker are a married couple and live in Springfield. Dr. Yang received her medical degree from Yale University School of Medicine and completed residency training at Massachusetts General Hospital. She is an anesthesiologist at HSHS Medical Group. Parker has helped formulate and administer public policy at various city and state governments around the country. He is formerly the group chief information officer for education with the Illinois Department of Innovation and Technology. This column is not intended to substitute for professional medical advice, diagnosis or treatment. The opinions are those of the writers and do not represent the views of their employers.
This article originally appeared on State Journal-Register: Health Matters: 6 things you (probably) didn’t expect when expecting
