This is my story about my wife and I’s birthing experience at OU Physician’s and OU Children’s Hospital. My wife and I were having twins and as a vegetarian and nutrition author we both opted to go drug and intervention free. We enrolled in a Bradley method class because it aligned closest with our beliefs and intentions. As we know and the Bradley method reminded us, sometimes interventions are needed but there are many that are not necessary. My wife did need some interventions which is just fine, but the way the doctors and staff treated non-medicated routes for low-risk consequences was completely unacceptable. Lack of proper nutrition in the hospital setting and the prevalence of drug offerings was deplorable.
At 32 weeks my wife had an ultrasound scheduled and it was discovered her cervix was 75% effaced and she was 4cm dilated. At this point we were admitted to the hospital. They wanted to administer a steroid shot to help the baby’s lung development. While Madeline was 4 lbs and 12 oz Mabel was only 3 lbs and 11 oz. Mabel was not showing signs of moving her diaphragm at the time. Their age and weight made them susceptible to issues and with signs of labor it was a precautionary measure. In both of our opinions it was a good choice to make.
When admitted to the hospital the first thing they did after getting us situated in the room and her hooked to monitors was swab for Group B Strep (GBS). Immediately after the swap they wanted to administer the antibiotic just in case she had it. Outside of our desire to limit drugs and my issues with pre-emptive antibiotics the logic centers of my brain were kicking off because they were conducting a test just to prescribe the same measure if it came back positive. If they wanted to prescribe the antibiotic just in case then why the hell do the test? The test causes discomfort, takes resources, and costs money and is 100% utterly useless in the case they automatically administer the antibiotics.
If you didn’t notice I didn’t mention antibiotic anywhere in initial intervention discussion. In fact it’s not even related to the steroid shot. So why was this part left out? The antibiotic was a precautionary measure in the event of active labor and my wife was not close to active labor. Part of the related medications to the steroid shot was drugs to inhibit labor so in my mind there was a low risk of suddenly hitting active labor. After asking questions the nurse could not provide answers to we decided to forgo the antibiotic.
The only question we got an answer to was how long it took the test to come back and the answer was days. The next question we asked how long it would take for the antibiotics to take effect. Later the nurse returned with an answer of 4 hours. Since the process of labor normally takes much longer than 4 hours and my wife was given medications to reduce contractions the answer was really easy for me… Do not administer the antibiotic unless the wife comes back positive or labor begins.
My wife is a bit of a worrier though and the answer wasn’t that easy for her. As a nurse my wife also has a lot more faith in medical staff and advice than I do. To make matters worse the doctors commonly used scare tactics when talking to my wife when they wanted to convince her of choosing an intervention. Our doctor, Dr. Kate Smith, told my wife that 25% of all women test positive for GBS. While this may sound like a valid statistic it’s actually an irrelevant scare tactic. The real statistic in question is how likely is it a pre-term baby will contract GBS if the mother does have GBS.
Some diseases have very high incidence rates and very low rates of transmission. GBS is one of those… While 25% of women have GBS only 1 in 2,000 babies in the United States actually contract GBS. So if we look at these two statistics a mother with GBS has only a 1 in 500 chance of passing on GBS to their baby. Pre-term babies are about 10% of all births so even if GBS transmission occurred only in pre-term babies you’re looking at maximum transmission rate of 1 in 50 or 2% if you know you have GBS. So instead of telling my wife there’s a 2% chance your baby could contract GBS if you have GBS and you went into labor right now Dr. Kate Smith tells my wife there’s a 25% chance that she has GBS. Additionally you have to factor in the odds of going into labor right at that moment which most likely put the risk below 1%. It was a clear manipulation of statistics to induce fear for taking a medicated route.
The ultimate decision my wife made was to not take the antibiotics and as it turned out not only did she not go into labor but she didn’t have GBS either. While it may seem everything turned out for the best this issue caused tension between my wife and I, and myself and the medical staff. There’s no reason it had to be like this if they would have informed us of the desire to administer the antibiotics as part of the intervention or providing objective statistical information on the risks.
The steroid my wife was administered took 48 hours after the first injection to have full effect. I thought this would mean we could get released around 48 hours if everything looked good, but they actually wanted to keep my wife there for a week. Since we lived only 20 minutes from the hospital and I worked from home I saw no reason why we shouldn’t be able to go home. If she went into labor after that point it’s why we took that intervention step. And once again it’s not like labor was a process that instantly happens in the majority of all cases. If you want to talk about risks the risk of her having sudden labor is minute. Contrarily the hospital charges of $2,000 or so per night were guaranteed.
My insurance coverage is fantastic so it’s not like I was worried about having to pay the bills, but I’m still adamantly against waste particularly with medical expenditures. I asked the doctor what the benefit of staying at the hospital past that point and it was basically “to be safe” so that we don’t have to check out then immediately get re-admitted. While “being safe” was keeping my wife there over a false risk of a 20 minute car trip and the sub-par hospital nutrition and sleep disturbances had real, consequential effects on her and the babies.
Even though I’m a health enthusiast and nutrition author I understand people have the right to choose whatever die they want, but what I don’t understand is when organizations in health are promoting diabetes and obesity through their own nutritional offerings. The OU Children’s hospital cafeteria was appalling. There were absolutely no healthy meal options and even the healthiest snacks had refined sugar. The apples and peanut butter had your normal trans-fat, sugar loaded peanut butter. The yogurt was low-fat (which interferes with nutrient absorption) and contained either granola or fruit – both loaded with corn syrup. Even the hummus came with white flour pretzels instead of something healthier like rice chips, multigrain crackers, etc.
The cafeteria was loaded with plenty of other horrible foods as well to include fried foods, gravy, excitotoxin laden chips, soda, energy drinks, candy, and more. The vending machines on every floor offered more doughnuts, candies, and sodas. In fact the only place you could purchase something decently healthy was an independently run café. As a vegetarian their menu had limited options, but she still was able to get a grilled cheese and tomato basil soup. Not the healthiest of meals but quite a step above the cafeteria food.
So from the first night on my wife and I brought our own food, but from the first night on my wife also got her sleep interrupted. Even with as low risk as she was they still did their usual rounds and hourly checkups. It was not conducive to reducing stress and getting a good night’s rest – I wanted to convince her to go badly. After discussions the doctors and us kind of reached a compromise… One more day past the 48 hour mark and then we’d go home. We went home the next day and my wife was basically on bed rest.
My wife made it another eight days, but after returning for a follow-up ultrasound my wife had measured at almost 7cm dilation. Once again they admitted her to the hospital. Out of concern over the risk of having to have a cesarean section she was put on clear liquids only. Remember how I just talked about how bad the nutrition was at the hospital? Well their clear liquids aren’t much better… From concentrate, sugar laden, GMO containing “juice”. The literature is pretty clear that sugar sweetened beverages contribute to diabetes and obesity yet this is what they’re saying is my wife’s only option.
Now the confusing part about this decision is that liquid foods don’t carry any additional risk of aspiration if she were to consume anything else pureed like a green drink, smoothie, etc. Even the sugar water they were giving her contains a solid form of sugar. If the hospital is going to give juice to patients though why not give patients something that doesn’t cause obesity or diabetes like 100% real juice?
After another sleepless night at the hospital and no signs of labor a doctor we had never met before came in the room to tell us we needed an intervention. She recommended that we break my wife’s water now to induce labor because they didn’t want her going another two or three days dilated so much. The problem I had with this route was that Dr. Lambert said if labor didn’t start naturally 3 – 4 hours after breaking the water they would administer Pitocin and schedule a cesarean section if the Pitocin didn’t cause labor after 6 – 8 hours. So now we were being presented with an option that leads to a medicated birth within 3 – 4 hours and the worst case scenario in 9 – 12 hours total.
I can’t say I was a fan of this so once gain I started asking questions… I first asked what the risk was of not breaking the water until another day or two to see if labor would start naturally in that time. The first risk I got from Dr. Lambert was my wife’s emotional state and her not being able to handle her current condition. I lost a lot of respect for Dr. Lambert right then because not only is my wife’s resolve pretty amazing, the doctor hadn’t even asked my wife how she was feeling emotionally. The second risk I got from Dr. Lambert was that risk of infection was really high. Dr. Lambert said her “biggest fear” of the entire birthing process was infection. I mean screw all the concerns and complications of anesthesia and cutting my wife open, the risk of infection to unborn children in an amniotic sac in a women on bed rest in a hospital is apparently tremendous. When I asked Dr. Lambert what are the statistical chances my wife could get an infection in her current setting her response was, “I don’t actually have any numbers.” You know what my biggest fear is? Doctors who medicate and prescribe interventions without even knowing the risks and statistical outcomes… Because Dr. Lambert used “biggest fear” without actually knowing the statistical risk of infection I can’t see her actions as anything other than scare tactics to prescribe standard medicated interventions.
My wife and I decided to wait before making any decisions. After talking with our doula we were informed that after the water broke we had around 24 hours before a real intervention was needed. This is a much greater timeframe than the 9 – 12 hours Dr. Lambert provided. We decided that we would wait for a while to see if labor started naturally, proceeding to break the water if it didn’t, waiting 6 – 8 hours to start Pitocin, and another 6 – 8 hours after that to schedule a cesarean section. While it’s essentially the same plan it gives us a much larger window to have a non-medicated birth.
During our stay at the hospital, both the initial admittance and the current one, we expressed to every doctor and every nurse we encountered that my wife didn’t want any drugs and wanted to do a drug free birth; however, every single nurse and every single doctor offered my wife needless medication. My wife was offered medication for acid reflux, headache, nausea, pain, and sleep. Pretty much every ailment expected in pregnancy a medication was offered. She was offered vaccines and flu shots as well. Every doctor reminded her that pain medication now and during labor was available. In no way shape or form was the hospital respecting our desire for a drug free birth. At the end we even asked some nurses not to offer medication and they still did. One nurse even boasted about our decision to go drug free then offered medication within hours.
Now my biggest pet peeve with medication is that Pepcid was continually offered at almost hourly intervals. While I understand that women have acid reflux like conditions during pregnancy the condition is caused by physical pressure on the stomach forcing the liquids up the esophagus. This condition is much, much different than acid reflux. In this particular case Pecid will make the condition worse and lead to poor digestion leading to poor nutritional absorption. Less acid means slower digestion. Slower digestion means more food and acid can be pushed up into the esophagus. Combine the effects of Pepcid with the poor food the hospital is offering with antibiotics that kill gut flora and women are in for some serious combinatory effects. I guess people don’t normally notice as much because they expect birthing to be awful and are mostly medicated…
After about 8 hours of continued transactions and labor not starting my wife wanted to break her water and try to induce labor. My wife’s water was broke and contractions immediately began to increase in intensity and frequency. After 4 hours she was in transition. After another 30 minutes she was in active labor. The doctor was called and the OR was prepared. At OU Children’s they deliver all multiple births in OR with a team for every baby. While I like the precaution it comes at a cost…
The anesthesiologist was called in and immediately began discussing the epidural without even asking if we wanted an epidural. Even after expressing she didn’t want an epidural he continued to try to convince us to get an epidural in case we had to do a cesarean section. I once again expressed no drugs. The first thing the anesthesiologist tried to do when we got into the OR was give my two drugs we had not discussed. While we went ahead and opted for the first drug we opted out of the second. I was speaking for my wife and this point and the anesthesiologist did everything he could to try to scare me my wife was in danger if we didn’t.
While my wife had been very pleased with Dr. Katie Smith to date I was plain pissed off at the events surrounding active labor. Throughout the entire pregnancy we informed Dr. Smith that we were using the Bradley method. As soon as my wife needed to push with me standing by her side Dr. Smith instructed her how to push in a manner contradictory to the Bradley method. I do believe that Dr. Smith should be familiar with the Bradley method as an OB/GYN even if she doesn’t recommend it, but she should definitely be aware of it and it’s basic principles. It’s also referred to as husband based coaching so Dr. Smith should be well aware that I, the husband, would be coaching her on pushing. Active labor in the OR is not the time or place my wife should be getting mixed signals. I asked Dr. Smith to let me coach my wife how to breathe and push and Dr. Smith told me if she didn’t push well enough it would be my fault and she’d need a cesarean section. Once again Dr. Smith is using scare tactics to try to change our birthing plan into whatever it is they want to do.
After Mabel was born I asked for the baby for skin to skin contact and feeding. Dr. Smith straight up told me it wasn’t going to happen and unless we evolved to have three arms it was impossible. Outside of being an idiotic statement because it flat out ignores the possibility for someone else, like you know me, to hold the baby to her chest while she continues to labor, she also flat out lied about that being our plan prior to entering the OR. I asked to make sure it was an option and she said yes. The Bradley method not only supports this as well, but suggests in can aid in the delivery of the second baby.
The delivery of Madeline was very smooth. It only took 6 minutes after Mabel was born. I can’t say I felt supported by the hospital, doctors, or staff, but the babies and mother are alive and well. Since Mabel was 3 lbs and 12 oz and Madeline was 5 lbs and 2 oz they’re both spending time in the NICU, but the NICU staff has been amazing. They have been supportive, informative, and as kind as anyone could expect. While the delivery made me second guess the hospital choice there is no other place that I wanted be afterwards. Well… Except for a place with a decent cafeteria too…
So that was our experience with the hospital and staff from my perspective. The lessons I learned I would recommend anyone to do are:
- Be confrontational early on with the hospital and doctors.
- The decisions get harder as the process continues so if you or the doctors can’t handle it it’s best to figure that out now.
- It will expose how your doctor will handle your choices and input prior to being in a position you don’t feel you have room to argue.
- Plan for nutrition.
- Bring liquids and solid foods if you can.
- Dried fruit, nuts, tea, juice, etc.
- Anything that is nutritious, filling, and easy to store.
- Plan out meals.
- Figure out when the hospital food services are available.
- We had several times we were hungry but nothing was open.
- Find restaurants in the area you can pick up food from easily.
- The first question should be to find out time constraints.
- Most of the decisions we had to make were not time critical.
- Finding out how much time you have can alleviate unnecessary worry and pressure.
- It gives you room to ask other questions and do research yourself.