Issue 5 Stories
Womens Health

Letting Nature Take Its Course

Facilitating a Natural Birthing Experience in a Comfortable Hospital Setting

The birth of a child can be one of the happiest and most memorable milestones for a family, so choosing what kind of birthing experience to have can be a major decision. Many women prefer to have a natural childbirth, with little to no medical intervention. And for some, the best place to have that kind of birth experience is right at home.

For those who want to design a personalized, low-intervention birth plan in a hospital setting, however, Sentara Martha Jefferson Hospital and Sentara RMH Medical Center offer a wide range of options. Caregivers at both hospitals are committed to providing the resources, education and guidance every woman needs to feel confident in her pregnancy and birthing choices, and to maximize the chances of having the birth experience she desires.

Designing a Low-Intervention Birth Plan

Healthy, low-risk patients—for example, those without complicating conditions such as high blood pressure—may be candidates for low-intervention labor and delivery. There’s no one “right” way to do a low-intervention birth, so women should discuss their personal preferences with their OB-GYNs. Many options are available, including intermittent monitoring and intravenous (IV) fluids so she is not attached to monitors or an IV constantly, increased mobility so she can get up and move around, and declining medications to manage pain.

“Low-intervention birth means making it possible for a woman to allow her labor to progress on its own, without being on a strict timeline or requiring medications to speed up the labor,” says Brooke Kilfoil, MD, of Jefferson OB-GYN. “It’s about allowing women to trust their bodies through the labor and delivery process.”

Patients with a higher risk for complications—such as those who require antibiotics during labor and delivery, or those who have experienced excessive bleeding following a prior delivery—may not be candidates for some of the low-intervention techniques.

Preparing for a Low-Intervention Birth

Sentara providers begin to have discussions with expectant mothers in the second or third trimester of pregnancy about the changes their bodies go through during pregnancy, and what to expect during labor and delivery. Doctors also give patients a chance to express their birthing preferences, opening up conversations about the risks and benefits of those options.

“By the time we begin these discussions, most of our patients will have done research on their own and have ideas about what they want their birthing experience to look like,” Dr. Kilfoil notes. “We always try to accommodate their preferences, but there are times when we may have to steer them in a different direction, due to medical concerns. These discussions are critical to helping ensure that each new mom has a positive birthing experience.”

Patients also are encouraged to tour the birthing facilities at Sentara Martha Jefferson and Sentara RMH during pregnancy, and to take advantage of the childbirth, breastfeeding and family care classes offered at both hospitals.

Delivering in Comfort

The Sentara Martha Jefferson Family Birthing Center and the Sentara RMH Family Birthplace offer comfortable birthing rooms that are designed to facilitate low-intervention techniques. Each room is equipped with items to promote nonmedical pain management, including whirlpool tubs, birthing balls and birthing stools. Portable fetal monitors allow patients to move freely during labor, and special fetal monitoring equipment can be used while patients labor in the whirlpool tubs.

Patients also may invite a limited number of care partners into the birthing room, including spouses or partners, doulas and midwives, or family members.

The recently redesigned Sentara RMH Family Birthplace offers a unique space, providing a more homelike feel than a traditional birthing room. Reserved only for patients with the lowest risk factors, this spacious suite offers a full-sized patient bed without rails or stirrups, and emergency medical equipment that is out of view. The room also includes a Jacuzzi tub, sleeper sofa and rocking chair.

“For the patient who dreams of having a home birth but also would like to have the security of a hospital, this suite is the perfect option,” says Terri Horst, manager of the Sentara RMH Family Birthplace. “The suite gives patients the feeling of an at-home birth, but in a safe environment with an experienced medical team that is ready to intervene if a problem arises.”

Patients wanting to give birth in this special suite should discuss this option with their caregiver. Those who meet the low-risk criteria will be required to sign an agreement acknowledging their understanding that risk factors may develop during labor that could result in the need for medical intervention. Should such a need arise, the patient would be transferred to another birthing suite that offers many of the same amenities.

Changing the Plan

Like many physicians, Dr. Kilfoil emphasizes to her patients that a birthing plan—even one with careful planning and forethought—can change at any time. In some cases, problems may arise during the labor or birthing process, leading doctors to recommend an intervention.

Dr. Kilfoil says OB-GYNs try to prepare each patient for that possibility during prenatal visits, explaining potential interventions such as induction of labor, episiotomies, Caesarean sections and operative vaginal deliveries (which involve the use of forceps or a vacuum device to assist with delivery). While these procedures occasionally do take place, they typically are reserved for cases in which the health of the mother and/or baby may be in jeopardy.

At Sentara Martha Jefferson and Sentara RMH, even C-sections can have a low-intervention feel, however. The “gentle C-section” allows patients to watch their baby’s birth through special transparent drapes. These devices protect the sterile field, while allowing the mother to feel connected to her baby during and immediately following the birth.

“If a C-section becomes necessary, this is an excellent option for some patients,” Dr. Kilfoil says. “It’s still surgery, but this approach allows moms to feel more involved in the birthing process.”

“The medical teams at Sentara Martha Jefferson and Sentara RMH are very supportive and encouraging of healthy, low-risk patients who wish to labor naturally in the hospital, without interventions,” Dr. Kilfoil adds. “In fact, that’s what I encourage for my patients—but we have all the tools we need right there in the hospital if a problem arises. Our ultimate goal is to provide a safe, positive birth experience for every patient.”

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