Saturday, March 9, 2013

Labor / Delivery Rooms

In the Denver area, delivery room options are pretty limited. I say that having no idea what the options are like in the rest of the USA. In Germany, the labor/delivery room options were quite different than they are here in Denver. I find myself missing the German options lately.

There are probably many different reasons for the wider variety of options in Germany. I think the largest contributing factor may be that prenatal and birth healthcare standards in Germany are arranged in such a way that women tend to do more 'shopping' for their birth location. OBGyns who offer prenatal care are (usually) not the same OBGyns who deliver at the hospitals. By severing the prenatal physician from the birth and labor physician, clients are less restrained in their birthing choice. As a result, hospitals and clinics spend more time competing for the business of birth, and that contributes to an environment of more and better birthing location options.

If the choice were mine alone to make on this my third pregnancy, I would seek out the one mythical midwife in the whole state of Colorado who does home births and I would have a home birth. But Fritz is staunchly opposed to this, and three births in, I know he will never change his mind, so to the hospital it is. 

If I want to keep my OBGyn for the birth, then I'm limited to the two hospitals at which she works. As far as I can tell, there's almost no difference between these hospitals. They are both filled with labor rooms that are essentially a bed with stirrups surrounded by cabinets with laminated with fake wood. The windows stare out onto the ugly facade of an adjacent building. The halls are more or less anonymous neon lights and endlessly institutional (even when they are full of baby photos by area photographers - does the hospital corridor have to be another outlet for commercialism?). Very few soft surfaces, no trees outside, no real plants, no direct sunlight, and NO, you are not leaving the labor ward because there are Security Measures In Place.* The fake wood cabinets house a tremendous amount of medical equipment for the use of the medical personal. They have a couch for the partner to sit on (I suppose). They have jacuzzis that are mostly the size of the bathtubs in my house.

That last part, the jacuzzi, motivated me to take a tour of my OBGyn's second hospital last week. Three years ago, with Mattias, I just picked the closer of the two hospitals at which she was registered, and went there. 

(I've had two really similar births, even though one was in the US and one was in Germany. The quick versions: (2x) 12 hour labors, 1 or 3 days past due date, (2x) unmedicated, (2x) arrived at hospital 7 cm, (2x) gave birth about 3 hours later.) 

With Mattias, here in Denver, the hospital was fine, my doctor was fine. But neither one was anything extraordinary. But then, does it need to be extraordinary? No, Fritz would argue: we want uncomplicated and safe. And that's what it was. So that's good! But the one thing I still find myself grumbling about was the size of the so-called jacuzzi at the hospital I went to with Mattias. It was too small - and let me tell you, hanging out in the water would have been great - if only there'd been more space in that jacuzzi. I don't necessarily want a water birth. But I'd rather have those contractions in the water than anywhere else.

The second hospital - my other birthing option if I stick with this doctor - had jacuzzis that were about 6  inches wider. Well, now, I suppose that might make some difference. But it clearly wasn't a night and day difference. The more I talked to Fritz about it, the more obvious it became that my change to a new hospital was threatening to him. 

It's taken me a while to realize this, but he really, really doesn't like change. He likes stability. He wants to know what to expect. He gets all flustered and nervous when you switch things around. He supposed I could go to a different hospital...but he was awash in the idea of CHANGE. After some consideration, I decided that maybe 6 more inches of width in the jacuzzi wasn't so important after all. I'd rather have a calmer birthing partner.

This seems pretty representative of a supposedly nice delivery room here in Denver.
Although, I borrowed this image from here, so maybe it's not even American.

So anyway, it will be off to the boring, ugly delivery room for me in April. But because it's hard for me to let go of these things and because I thought maybe you'd like to see some different options from Germany, I hereby present: 

Labor Rooms from Germany:

Family Labor Room in Asklepios Klinik Sankt Augustin. Image from here.
I don't really need to say anything about the size of that birthing tub, do I? (Awesome.) And how about those windows streaming in all the beautiful light? I like the warmth and energy of this room! (You might already know how biased I am towards red....) No fake wood cabinets. 

See the pieces of fabric hanging from the ceiling? They're probably Didymos slings. Six years ago, when I was doing hospital delivery room tours in Munich, the midwives showed us how women like to hang their arms through them to support their upper bodies during delivery. Apparently the swinging and rocking is also quite nice. I didn't end up using one, but the slings were omnipresent in almost every delivery room in Germany I visited. I still find myself looking for them in US delivery rooms. Never seen one here in Colorado.

Labor Room at a midwife practice in the Heidekreis-Klinikum in Walsrode
Look! This delivery room comes complete with a medicine ball, birthing stool, and plant. Also, the omnipresent sling in pink and yellow.

Labor Room at Klinikum F├╝rth. Image from here.
Look at that birthing tub in the lower right hand corner! Complete with rubber duckies. (I don't know, sometimes this stuff is kind of silly, right?) The sling, the medicine ball. The new addition in this photo is the coral, crescent shaped pillow on the bed - that's most likely this popular pillow in Germany (from the UK) which is a cross between a Boppy and a body pillow filled with "micro pearls." It's similar to a beanbag chair in density, but not so lumpy. I have one from my pregnancy in Germany with Noah, and I'm still using it this pregnancy. Love it. I've tried to find them here in the States, and I can't. It's a really great pillow because you can use it both pre- and post- natal, both mama and baby.

Hopefully, this wasn't too negative about comparing. (My mother always feels personally offended when I start comparing the US to Germany.) Sometimes, I think it's good to see how they do things other places, if for no other reason than it might help raise the standards and make everything a little better if we know what we're missing!

*Being an architect, I do recognize that building regulations have a significant impact on hospital and healthcare design. Unfortunately, I think that economic efficiency has an even bigger impact on design - and that's something that could be changed if we voiced our preferences.


Sara Struckman said...

Sounds like you have pretty "easy" labors. Mine were similar. The first about 12 hours, unmedicated. The second about 4 hours, unmedicated. I also stayed at home until I was about 7 cm dilated. The difference: My first birth was at a birthing clinic in Austin. And it was an amazing experience. I was very limited in my second birth because my healthcare was with Kaiser, so I essentially had one option - St. Joseph's. The plus side is that it's five minutes from my house. It was very stark and sterile. But, I was only there for two hours before Lila arrived, so I really couldn't tell you much more about it.

Have you considered a birthing center? There's only one free-standing one in Colorado and it's down in Englewood. Not very convenient. Sounds like your husband might not like it much though. My husband was the same. Although he liked the birthing center, he said it made him uncomfortable. He was much more secure in the hospital setting. However, I have to say, I was not. We hired a doula the second time around because I really wanted to make sure that someone would advocate on my behalf.

In the end, both births were relatively "easy" and I don't have much to complain about. I definitely preferred the birthing center though. Good luck with your decision.

Ann Wyse said...

It definitely sounds like our husbands are similar! I checked out Englewood when I was pregnant with Mattias - and I definitely liked it better than the hospitals...

But, yes, Fritz nixed the idea because he couldn't really believe that a comfortable setting (for me) was preferable to a setting with all the latest technological gadgets (for both mama and baby and, ah-hem, papa)!

Pregnantly Plump said...

Those do look really cool. I say the hospital is a good idea as well, but just because of our experience with Little Elvis' pregnancy, and the last minute C-section. It was really scary, and good to be that close to the surgical room. I didn't do a delivery room with my last two, since they had to be c-sections as well. The surgical suite thing was all white and silver and sterile - literally and physically cold.