Top Eight Mistakes Pregnant Mothers Make at the Hospital

(As arm-twisted out of an American labor-and-delivery nurse by Thingamababy)

8. You don’t use your call light enough. When you need something such as pain medicine, help nursing your infant or just a cup of water, you sit and wait instead of calling for me. You don’t want to be a bother? Well, it’s not a bother. It’s my job.

[This point sparked some strong reader reaction. See my response below. If friends tell you your hospital is bad, look into getting a doula.]

7. You overpacked your hospital bag. It’s nice to have three bags of groceries, your entire music collection, and five suitcases with you in your room. If you throw up on your cashmere sweater, you’ve lost it. If you drop your $300 cell phone in the toilet, the hospital isn’t going to replace it for you. Bring what you need, but not your nicest things or so much stuff that it’s difficult for people to maneuver in the room.

6. You don’t drink enough fluids. Labor is a marathon, and
you need to drink and drink and drink. After labor, you need fluids to
replenish what you lost (sweat and blood). You are inundated with a
million issues now and it’s easy to forget. Dehydration is a real
problem.

5. Your doctor doesn’t know your birth plan. Those words you
wrote
on a piece of paper are not a contract with the hospital. They
are your dream for your perfect birth experience. Sharing your dream with your nurse is great, but if your doctor isn’t familiar with it, you lose.

Talk to your doctor a few weeks before your due date. If you want
anything mildly controversial (for example, refusing an IV, fetal
monitoring or antibiotics), talk it over much sooner because your
doctor might not agree and you’ll need to find a different
practitioner.

4. You kept secrets from your partner. If you have a
sexually-transmitted disease, mental health history, drug dependency or
abuse history, it can impact your care, or your baby’s care. It may
cause strife with the people supporting your birth when they don’t
understand why you or the medical staff are doing certain things. The
more levels of deception you sustain, the harder you’ll find your birth
experience. Don’t let the birth turn out like a bad sitcom.

3. You have too many visitors while you’re in labor. There
are only two sides to your bed, two people per side. Anything more than
four means folks are standing around. Sometimes this even means a party
with people watching TV, eating Doritos and doing everything except
supporting your labor. Pick 2 or 3 people to help you and let everyone
else stay in the waiting room or at home. Individuals can trade places,
or “work labor shifts,” but don’t overload yourself with a lot of people in
your room.

2. You have too many visitors after birth. Your newborn is
waking every two hours to feed, and you need to sleep in between. It’s
natural for people to visit to share in your joy, but the baby will
sleep when they are visiting (babies withdraw when they’re
over-stimulated) and be awake when people leave. When do you get to
sleep? This is a big reason why new parents feel lousy on Day Two and
Three. Give people a specific time period in which to visit each day to concentrate the interruption. You can still have a few trusted supporters be with you more often.

1. You let Dad install the infant car seat at zero hour. Big
mistake. When you are being wheeled out of the hospital, you don’t want
to find Dad wrestling with the car seat, realizing he doesn’t know how
it installs, or how it works, and that it doesn’t fit well in the car.
Buy and install it at least a month before your due date. Then seek out
a community car seat “checkpoint” or “station” to have the handiwork
inspected. Even when you take your time, the seat is often installed wrong. In the US, a law enforcement office or hospital may have
regularly scheduled times when you can drive up and have an expert
assess your seat.

Comments

23 Responses to “Top Eight Mistakes Pregnant Mothers Make at the Hospital”

  1. Airwick says:

    As to number one … sure it’s great to push the button when you need something, such as a glass of water or assistance with breast feeding. But that also means that your nurse should actually come in a reasonable time, or if she’s busy with another mom, some other nurse should come in to see what they can do for you. And yes, I am still bitter about the lack of support my wife and I received nearly 2.5 years ago. There was a consistent delay in response across all shifts (on the order of 20+ minutes minimum, and yes I did check the clock while DD was screaming that she was hungry). Yes I did then go out to the desk to inquire, only to be curtly rebuffed to go back to my room.
    And yes, we did speak with both the charge nurse and the nursing supervisor. And yes, this was at a supposedly great hospital in the greater Boston area. … Sigh … (this is not meant do disparage all the other great nurses working elsewhere … just those that we encountered post-delivery … on the other hand, our pre-delivery nurses were fabulously supportive!)

    December 11th, 2007 at 6:17 am

  2. Hans says:

    Your very first bullet would make sense if nurses actually want to help. Most of the time it is a big bother for them and you won’t see anybody come to see you without a longer delay. And if she shows up the nurse gives you attitude or is just showing to you how much she actually hates her job. My wife is pregnant with #3 and so far after a couple of births and multiple pregnancy related ER visits we’ve probably met only one or two nurses who were actually happy to help.

    Birth plan: they are cute, they are kind of helpful in the beginning. Most of the time, though, the well thought out plan goes straight out the window as soon as it is almost time to give birth. There is really only one thing you can plan beforehand: breastfeeding or not (and even that is subject to change depending on mom’s situation).

    December 11th, 2007 at 6:45 am

  3. Amanda says:

    We made a birth plan and went over it with our midwives a couple weeks before my due date, it was also sent to the hospital with my file. We arrived with extra copies and made sure our delivery nurse had read it. Everything went roughly according to plan and my wishes were totally respected. If your birthplan “goes out the window” when things get really get going, then you need to find a better provider or a doula to advocate on your behalf.

    December 11th, 2007 at 7:28 am

  4. AJ says:

    (Maybe only long-time readers know that my wife is the labor and delivery nurse. The following are *my* responses though.)

    There certainly are differences between hospital experiences. We were shocked when my wife’s high school friend called from her hospital bed in another state to ask for nursing advice. WHAT? Aren’t the nurses helping you?

    After-birth attention from nurses is less than before because the “emergency” is over; the baby is out. So it’s common to feel “neglected” after birth by comparison because your needs are fewer. Use the call light! (My wife says, when she hears the call light, she walks in within a couple minutes.)

    As for Airwick and Hans having simply lousy nurses, ouch, maybe talk to other families and pick a more supportive hospital if there is a next time. If that’s what you had done, maybe you gave birth during a particularly hectic time (a huge number of births hitting at the same time).

    And my wife says… if the hospitals are really bad, or you only have one choice, then you really need to find a doula.

    December 11th, 2007 at 9:19 am

  5. Tiffany says:

    Have to say I agree with AJ- my personal experience was great- and I had my son by C-section AFTER 24 hours of unmedicated labor (and 2 hours of pushing)- so needless so say I couldn’t get out of bed for a while even if I wanted to. And since my son was down the hall being monitored for a day, my husband was with him and not me- and the nurses were fantastic for me. And I did use my call button- but only when I actually needed something. And I tried to make sure I got as much taken care of in 1 trip as possible (don’t call them for water then 5 minutes later for jello). And I was in the hospital when they were so busy that 1 more baby would mean that the next person went into a regular ward and not maternity (how’s that for busy?). So really, I think you need to know what your hospital is like before you go. I’d already had 4 friends who had babies in that hospital within the year before I had mine, so I knew what I was getting into. Oh, and make sure you say thank you. Surprising how many people don’t say thanks when someone gets them water, apparently :) (as I was told by my nurses)

    December 11th, 2007 at 1:43 pm

  6. Amber says:

    About #6 – my nurses wouldn’t let me drink at all after I was admitted. The best I could do was eat a few ice chips. I was under the impression that this was standard procedure everywhere as I read it in one of my baby books.

    December 12th, 2007 at 3:20 am

  7. Homestead says:

    AJ-

    A rolling pin. We went to baby school and they told us to bring a rolling pin to delivery. For the record…. we did not do it.

    Does your wife have any thoughts about gifts for the nurses? I know… I know…. wtf? But with each of my kids my husband brought a simple box of chocolates to the central desk later that afternoon (both my babies were early morning babies) as a thank you.

    And after my second baby I wrote a thank you note to the hospital about the department and, specifically, my delivery nurse because she was amazing. I figure they hear all the time about what they do wrong… they might like to hear about what they do right as well.

    December 12th, 2007 at 10:45 am

  8. monika says:

    I delivered twice at the same hospital, and can say that during both experiences, I had a couple of amazing nurses, very involved, very caring, and actively trying to avert problems.

    Each times, there were duds. Actually, I had the same terrible — the worst nurse ever — each time. I would see her once a shift, she would start off proclaiming everything she would do that day, and then I would never see her again.

    Most are inbetween — i.e., you wait 20 or 30 minutes after calling, they come to help, and half the time they forget. Fortunately, I am pretty used to hospitals and pretty independant; only the first 24 hours after my c-sections was an issue.

    Have a doula or husband there at all times — my first time, my husband wasn’t there the first day (he hadn’t slept in 48 hours and crashed at home), nor was my doula (hadn’t thought to hire her for that day), and I was stuck in labour & delivery for 8 hours until a bed became available in post-partum. I was forgotten by all the nurses since I was no longer in labour!! It was awful. I called, and called, and called, but no one ever came, until 8 hours later, I was wheeled away.

    December 13th, 2007 at 12:41 pm

  9. grass says:

    Good points. I also agree that birth plans should be made known to providers. I disagree with the commenter that all plans go out the window once it’s time to give birth. A proper birth plan isn’t a dictate about how your labour will go, but rather a plan about how you want to be treated under the circumstances.

    December 13th, 2007 at 9:51 pm

  10. nd says:

    Wow. The fact that a birth is viewed as an “emergency” event by L&D nurses (quotes or not) is exactly why I chose midwives to attend my births. It is so sad that the medical profession has co-opted women’s birth experiences and turned them into an “emergency” that needs to be managed.
    My first birth was in a hospital birthing center, attended by my midwife and my ob. The care from the nurses was horrific. My IV insertion was botched, which resulted in extremely painful bruising. We were treated condescendlingly and the “nursing support” provided consisted of a nurse handing me nipple shields and a can of formula “in case the nipple shields didn’t help”.

    My second birth was in a non-hospital birthing center envirnoment. The only people int he room were myself, my husband and my two midwives. It was quiet, the lights were low and my son was born in a big comfortable bed. It was a dream birth experience.

    December 14th, 2007 at 8:56 am

  11. AJ says:

    ND, the word “emergency” is my word choice (it’s in my comment, not the article my wife reviewed). My nurse-wife doesn’t use the word. Don’t read too much into my use.

    I mean to convey the gravity of the event. If everything goes well, great, it’s a rather peaceful family experience. Note that the article repeatedly uses the phrase “birth experience” not “birth emergency.”

    If a birth doesn’t go as planned, damn straight, it becomes an emergency. And believe me, we have midwives in our area and they are not immune from being faced with true emergencies because an emergency is usually caused not by the practitioner, but the mother’s physiology.

    And as a dad who has gone through a 36-hour birth, I’ll always consider it an “emergency” — something that requires immediate and ongoing observation and care whether by a midwife, obstetrician or family practitioner.

    December 14th, 2007 at 9:17 am

  12. Mama Peach says:

    My L&D nurses were INCREDIBLE. After 33-hours of labour (unmedicated, and NOT by choice, the epi didn’t work) and a crashed C-section, they completely have my respect and were my rocks.

    The post-care nurses, and the NICU nurses (as that is where my daughter was), well my experience was HORRIBLE. Too awful to write.

    Next time – YES – I will have a doula.

    SARS here in Canada prevent more than two people from being in the delivery room (DH and Doula = 2! Problem solved).

    I completely agree with your wife about visitors after the fact. My family was the icing on the cake of what I consider a truly craptacular birth experience. Next baby, NOONE will be visiting us at the hospital. I am prepared to deal with some MAJOR backlash over this. It almost makes me wish it were hospital policy to not allow visitors post-delivery.

    December 14th, 2007 at 11:41 am

  13. Paula says:

    This is so helpful, and something I haven’t seen before. (Blogged it on this week’s webwrap at http://www.thenestbaby.com.) Thanks.
    I definitely agree with #2, about talking the birth plan over with your doctors long BEFORE it’s time to give birth. Since your doc or hospital may not agree with or be able to carry out everything you’d like to happen, it’s good to discuss this far in advance so you can figure out a plan that you’re both satisfied with.

    December 17th, 2007 at 8:28 am

  14. Marianne O says:

    AJ, I always enjoy your articles and comments… but oh boy do I have to dispute the comment that “an emergency is usually caused not by the practitioner, but the mother’s physiology.”

    There are some emergencies that have nothing to do with the practitioner or environment. However, these are (thankfully) few. Evidence strongly supports the position that most obstetrical “emergencies” are in fact iatrogenic, i.e. either caused by, or aggravated by, the practitioner/care environment. A very simple example is the “white-coat” response to procedures, e.g. blood pressure going up in a clinical setting, as compared to the lower pressure found in a less clinical setting.

    I would argue that obstetrics is by FAR the most iatrogenic of all the health disciplines. As a former midwife, I admit my bias here. But the evidence really does speak for itself.

    December 17th, 2007 at 9:15 am

  15. AJ says:

    Marianne, it’s true given that most pregnant women are young and healthy. People who are going to use low-risk settings such as birth centers and their own home are self-selected and generally even healthier than the healthy population at the hospital.

    However, (my wife says) no one in their right mind has ever mistaken white coat syndrome for an emergency.

    I’ll add that a hospital serves *everyone*, and you’d be surprised, shocked and saddened by the folks who fall on the unfortunate end of that spectrum.

    December 17th, 2007 at 9:36 am

  16. Marianne O says:

    Of course, white coat syndrome isn’t an emergency… it’s just the most basic example of an iatrogenic condition. Let me give you an example that DOES involve an emergency:

    - A woman’s labour is progressing slowly. There are many possible causes, but for our purposes let’s say it’s decided that she’s dehydrated.

    - Choices for hydration include oral fluids or an IV. But hospital X’s policy is no fluids by mouth in active labour. So she gets an IV. (whereas in a different hospital, or other environment, fluids by mouth might be OK).

    - IV restricts mobility. She stops walking around and lies down. The woman is also quite upset about needing an IV as she hates needles. Progress slows further.

    - To address the continued problems with slow progress, pitocin ( a drug to stimulate contractions) is added to the IV. The woman is quite worried that labour will be unbearable with Pitocin, and requests an epidural (not in her birth plan).

    - Severe fetal heart rate decelerations are noted, and the woman’s uterus is hard as a board. It is determined that a placental abruption is happening. This is a life-threatening situation for mom and baby. A “crash” C-section is ordered.

    Now, there’s a clear link in the research between pitocin augmentation and placental abruption, even under the most diligent care. We also know that provision of fluids by mouth is safe in moderation (despite the widespread & long-standing policies against it).

    Would this PARTICULAR abruption have happened if oral fluids had been given, and the IV avoided? Who knows. Could have happened anyway. But we do know that statistically, across a large population, a less interventive setting produces far fewer emergencies. Hence my comments earlier.

    By the way, my midwifery training included obstetric rotations in very poor and disadvantaged communities. I’m aware that not everyone is low-risk. But even the moderate to high-risk folks face extra risks in an intervention-happy environment.

    I don’t want to bore anyone here (too late, maybe???) so am happy to continue the discussion off-line if you’re interested.

    Cheers

    December 17th, 2007 at 10:17 am

  17. Marianne O says:

    Should have noted above that fear (e.g. of needles) is also well-documented as a factor in slowing down labour…

    December 17th, 2007 at 10:20 am

  18. AJ says:

    Marianne, I think we’re splitting hairs. Yes, for mothers who are low risk and can handle a minimally attended labor, hospitals can involve complications because of policies due to medical-legal reasons, but many if not most people don’t have those options where they live.

    My wife has witnessed home births gone wrong (handled as emergencies when they arrived later at the hospital). I wouldn’t (and she wouldn’t) point to those as examples of why not to choose a home birth. And my wife has witnessed physiological issues where a birth goes bad that clearly cannot be blamed on anything except fate. For example, a uterine rupture will certainly cause two deaths at home while the mother might survive at a hospital.

    Is it a far-fetched example? Sure, just as is your scenario of a pitocin-induced rupture. And yet, I’m sure you and my wife have seen or heard of both occurring.

    What it comes down to (for me) is that hospitals, birth centers and home birthing are all valid settings. There’s a place for everything and not everyone needs a hospital. It’s an issue of where you are most comfortable.

    Incidentally, my wife originally wanted to be a midwife, until the realities of living your life on-call set in.

    December 17th, 2007 at 2:44 pm

  19. Marianne O says:

    Awwww, man… just finished typing out a masterpiece of a response (or so it always seems with hindsight) and it got blown away by the dreaded refresh of death. So allow me to use point form.
    - I don’t think we’re really splitting hairs here. There’s no home vs. hospital bias here, I’m happy in either. There ARE some great hospitals around….likewise some great OBs and labour/delivery nurses.
    - Actually, the whole anxiety-slow progress-augmentation situation is not unusual. Slow progress is in fact the #1 factor cited in labour interventions… and side effects of pitocin are pretty common. I admit I picked abruption because it makes a colourful example. Yes, it’s rare. I suppose I could come up with a situation that your wife would consider more common or balanced… but honestly, the research literature is full of this stuff. Surely this is not new information to her.
    - Even my very favourite nurses & obstetricians (who happen to be both reasonable and midwife-friendly) find it hard to impossible to believe that hospitals create as much risk as safety (at least in low-risk cases) and thus overall it’s a wash. This just goes against every nerve fiber & bone cell they’ve got. So I’m under no illusion that posts here are going to change anyone’s mind. But I do appreciate the opportunity to present the case.

    December 17th, 2007 at 5:39 pm

  20. Jessica G says:

    I planned on having both of my girls in hospitals attended by a midwife. My first birth was midwife delivered. My second was OB delivered (he was the husband of the midwife who did not show up). I am a huge fan of L&D Nurses and think they are amazing.

    On the subject of gifts for the nurses (from an above posting) my husband and I had one of those “Edible Arrangements” delivered while I was still in the hospital- a big bouquet of flower shaped fruit. They went nuts for it. Said they always get sweets and candy but said that at least 2/3 of them were always on a diet so fruit was much appreciated.

    Fruit for thought.

    December 17th, 2007 at 8:07 pm

  21. AJ says:

    Whoops, I missed the thank-you question. The wife says… high quality pens and lotion.

    Pens… fat, easy glide, with clickers instead of lids. Apparently, her hospital-supplied pens leave something to be desired.

    Lotion… because she’s washing her hands all day.

    Chocolates and candy are a big no. Nice fruit like Jessica mentioned are a yes, along with organics, etc.

    December 17th, 2007 at 8:23 pm

  22. thordora says:

    My first birth in hospital was terrible all around-nurses from HELL “helping” me-no wonder I had to be induced. The after care as I hemoragged was interesting if nothing else.

    My second, great nurse with me during delivery, fairly oblivious afterwards.

    My experience has made me want to become a nursemidwife though-since I’d rather try and be part of the solution. Sadly, all I need to do is move to another province for that. :(

    December 18th, 2007 at 4:55 am

  23. mira says:

    I lucked out with a primary L&D nurse that was a midwife in England prior to coming to the states, and the secondary nurse was so good at her job that she was reading my birth tome while sitting on the floor with me while I was about 7 cm dilated. They seemed to appreciate the fact that I had come to the delivery room fully prepared for any outcome yet determined to make my doc approved birth plan work (provided everything was ok medically), and completely respectful of their experience and position as L&D nurses. Turns out I didn’t do any of the things on your list, perhaps that was why my labor and delivery progressed exactly as I’d envisioned ;-) My postpartum care was just as excellent.

    The only tip I’d add is “don’t come to the hospital too early” and note that timing will be different for everyone. I am convinced that the reason I was able to have an intervention and medication free birth was because 75% of my labor occurred in my own home, rendering most of my birth plan moot points!

    December 19th, 2007 at 11:39 pm