The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
[Jan., 2005] - I was just at a birth at Peninsula this past Friday/Saturday. The mom specifically wanted the tub. She was moved into room 2 (one of the rooms that adjoins the tub storage room.
We asked specifically for the tub to be prepared several times. We had a great nurse, Lisa, who really was a wonderful support in every way but she came back after a thorough investigation about the tub and said first, she wasn't trained on how to set it up and then, that it was broken and needed to be fixed and so was unavailable to the mom...
The mom used the shower and found good relief there but I believe she
would have benefited greatly by being in the tub. She had an OP baby
and lots of back labor pain. It would have been easier for her to
move around if buoyed up by the water (IMHO).
I haven't ever heard about renting tubs and bringing them to the hospital, but speaking of tubs I wanted to bring up an experience I had at Peninsula Hospital. I was working with a mom who really wanted to use the tub there and she let her midwife know this was important to her and then mentioned it again when she took the hospital tour and they told her she would be able to use it as long as the tub was available.
When she was actually at the hospital we asked for the tub and they said they would try to find it, but just to use the shower in the mean time. The next time we saw the nurse she said she was still trying to find a way to get it but that it takes 2 hours to fill up and that it's not usually worth filling it up because by the time it's full nobody wants to get in it, but we said we wanted to try it anyway.
Then she came back again with the hose that feeds water into the tub
and showed us that it actually didn't fit onto the faucet that was in our
room and the only faucets that worked with it were in rooms 1 and 2 which
were occupied so alas no tub. I just wanted to put it out there that
if you are working with anyone at Peninsula Hospital who wants to use the
tub which can be so helpful, it seems like it would be a good idea to ask
for it early as well as requesting to be in room 1 or 2 or bringing your
own threaded hardware attachment for a faucet with a wrench, hopefully
in the future they will standardize all of the faucets in the rooms to
be compatible with the hose. I was curious if anyone has been able
to use the tub at peninsula and what your experience has been?
I had a similar experience with labor support for a secundagravida. She really wanted the tub. It took some major convincing and smooth talking to get it set up. Meanwhile, laboring mom was in shower.
Finally got it set up . . . and the tub is really not what you might expect. It is not like the deep water tubs we use for homebirth. The whole point of the water for labor is to be fully submerged and have freedom of movement. Also, for comfort, safety and convenience it is necessary for the mother to be able to get in and out of the tub easily of her own volition. The tub at Peninsula has a molded seat that forces a reclining seated position. The water only covers the woman to her belly. There is a door with a latch. One cannot easily get in and out.
This particular laboring mother was in the tub for one contraction. Then, in a panic she said "get me out of here, I want back in the shower". Later she described that it was uncomfortable to sit in and the water was not deep enough to be of much comfort. Then we had trouble opening the door . . . aurgh . . . not very smooth or practical.
On the other hand, I still think Peninsula is hands-down the most mother/baby
friendly hospital in the area.
I can tell you that there are tubs in every room at UCSF and at San Francisco General as well as midwives that act as "attendings" (not just the "MD-lite"), teach medical and midwifery students in normal birth and some complicated and are there at all times. The tubs are regular bathtubs though a bit larger/deeper (at UCSF, I think they're Jacuzzi) and are in the bathroom so there's an extra door people have to go through to get to the laboring woman. Each of these hospitals has telemetry and waterproof dopplers allowing intermittent or continuous monitoring while in the tub, with many midwifery clients receiving intermittent monitoring or auscultation. There are protocols at each hospital for monitoring in the tub so the nurses know exactly what to do and (mostly) are happy to do it. I think that if she has an IUPC or FSE, she can't go in the tub but she can still be mobile because of the telemetry units. The laboring woman can have ruptured membranes or not, though I would suspect that is she was starting to have signs of infection then she could only use the shower. In terms of IVs, midwifery clients with no risk factors for PPH or GBS or other things requiring an IV have no IV or a saline lock and all nurses are more than happy to cover the IV for shower and/or tub. Sadly, neither of these hospitals "allow" waterbirth but I have been told numerous times at both hospitals that sometimes women can't get out of the water fast enough so there are some "suprise" water births :).
Sutter Santa Cruz does have tubs but I don't know about waterbirths.
I'm hearing more and more wonderful things about Sutter Davis Hospital.
The labor and delivery unit is run by midwives and *encourages* waterbirths
and doulas (through its volunteer program to women that can't afford them).
A classmate of mine used to be a doula there and she said that the midwives
didn't monitor the baby's heart rate during labor. This seemed odd
to her once we started school so she asked one of the midwives she used
to work with there and the midwife said, "Oh, we try to do it as unobtrusively
as possible but we still do ACOG guidelines (every 30 minutes in active
labor through one contraction and every 5 minutes in pushing)". Pretty
unobtrusive if the doula didn't even notice! The waterbirths take
place in an AquaDoula tub in an alcove of the room. It is a good
1.5 hours away :(.
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