eating in labour or else IV drip in labour; moving from room to room

[kpr]

Can anyone tell me if it is normal for the hospital to ban you from taking any food or drink (except "possibly a few sips of water") from the moment you arrive in the labour ward? The Belgian hospital I am going to be in also attaches you to an IV drip as soon as you arrive, to make up for all the food and drink they ban you from having.
And another thing that seems very odd is that when I arrive at the hosp I am put in a monitoring room, then in a labour room, then in an extremely spooky-looking delivery room as soon as I either start 2nd stage of labour or have an epidural.

[TheBlonde]

Not normal in the UK as far as I know

Do you live in Belgium?

[kpr]

I'm in the process of moving here (to Brussels) -as my partner's work is here, and as lots of people assured me that the maternity care here was a hundred times better than any I would have in the UK.

[TheBlonde]

Best ask the folk who told you the care was better then

NHS is a lottery so I wouldn't exactly recommend it

[belgo]

I'm in belgium, gave birth in Gasthuisberg, Leuven I had no drip, was given breakfast during labour (which my dh ate), had a totally natural labour. Then the doctor came in and tried to insist that I use the stirrups to give birth. I refused, and gave birth on my side. It helps that I speak dutch and used to work in that hospital, so know my rights and am confident enough to speak them. My next dd was born at home, with private midwives. Which hospital are you planning to go to? Have you heard of Brussels Childbirth Trust, an english speaking organisation that provides antenatal courses?

[Toady]

The NICE Caesarean guideline says

"Women should be informed that eating a low-residue diet during labour (toast, crackers, low-fat cheese) results in larger gastric volumes, but the effect on the risk of aspiration if anaesthesia is required is uncertain."

and "Women should be informed that having isotonic drinks during labour prevents ketosis without a concomitant increase in gastric volume."

In the draft of the intrapartum guideline (final version due out next year) it said

"H2 receptor antagonists and antacids should not be given routinely to women in labour."

and "Women may take a light diet during labour. "

and "Women should be encouraged to drink during labour, and be informed that isotonic drinks are more beneficial than water."

[shhhh]

"Women should be informed that eating a low-residue diet during labour (toast, crackers, low-fat cheese) results in larger gastric volumes, but the effect on the risk of aspiration if anaesthesia is required is uncertain."

and "Women should be informed that having isotonic drinks during labour prevents ketosis without a concomitant increase in gastric volume."

Which when translated says what..???!!! Is it just me who didn't really grasp what was being said..?

BTW when I laboured with dd I drank lucozade and the mw kept checking me and trying to get me to drink less lucozade. She encouraged dh to make me drink water and was concerned by the amount of lucozade I consummed..!! BTW it was only 1-2 bottles so not a bucket full..!!

[kpr]

I'm booked into St Luc's in Brussels - I realise now that it has a reputation for being very medical. Very helpful to know that you managed to refuse the doc's instructions to use stirrups. Yes we're going to BCT classes.

I think I will just stay home as long as possible so I can eat and drink, and will also discuss with the doctor here the advice from nice - thanks for that.

Belgo, can I ask whether your 1st delivery was mainly managed by midwives or by a doctor?

[belgo]

My first delivery was managed by midwives, the docter came in only at the last bit. It helped that I had seen one of the midwives during my pregnancy - I had my pregnancy checks with her rather then with a doctor - so she knew what I wanted and fortunately was on duty when I went in. I stayed in hospital for five days afterwards, and it was lovely - my own private room with ensuite and fridge. The food is good too (beware of horse meat in sandwiches ) All in all, I prefer Belgium hospitals then NHS.

[belgo]

There are some hospitals /birthing centres in Belgium that are far less medicalised for giving birth.

[shhhh]

"horse meat in sandwiches" ...And you say you prefer NHS hospitals..!! .!!!

[belgo]

shh - yup horse meat in sandwiches and it's not very clear unless you know the flemish word for horse (paard)

[shhhh]

barrffff..................

[belgo]

Apart from that the food in Belgian hospitals is great, far superior to NHS imo.

[belgo]

And some hospitals here even give you low alcohol beer. And if you bf, then you get more food.

[Gemmitygem]

hi kpr

I'm 39 weeks preg with my first and due to give birth in Antwerp..

I would personally refuse the IV and just eat and drink when they're not looking. It's a very very long, arduous physical effort, and as I see it a bit of energy is essential. I'm not talking about eating a full meal in labour, just about isotonic/energy drinks and juice, plus things like chocolate, boiled sweets to suck on, that kind of thing.

My understanding is that the reason for not eating is for the very unlikely case you would need a general anaesthetic (as most CS are done with a spinal nowadays anyway this is unlikely to occur), and even if you've eaten you can still have a general anaesthetic (car accident victims etc).

I think it's very important to brief your birth partner/husband on what you do and don't want, so they can advocate for you. After all, the hospital is only making recommendations. They have no right to do anything to you (e.g. insert an IV, which instantly makes you less mobile), or to physically stop you eating or drinking. They can only pressure you to fit in with their protocols.

It sounds like a very medicalised hospital, and I would seriously ask yourself whether it's too much for you personally. A lot depends on who your obstetrician is as well I suppose. I'm choosing Belgium because of the great aftercare, but am very aware that I'll need to be ready to refuse procedures and go my own way to a certain extent.

My four main things for labour are: (don't know if useful for you but just a reflection of trying to remind them of my basic rights!)

1. I will eat and drink as I see fit (better not to say this directly to the medical staff, but my husband has been briefed). The Antwerp hospital said 'as much clear fluid as you want', e.g. juice is OK. But if I want a bit of chocolate, no one has the right to stop me having it!

1. I will give birth in an active position such as hands and knees, sitting, or perhaps lying on my side, but not lying on my back or in stirrups (much harder to push, higher risk of tears). This applies even if I had the epidural

1. If I am continuously monitored because I had the epidural, I would still like to remain as upright as possible (e.g. kneeling, sitting)

1. VERY IMPORTANT, I do not want an episiotomy unless it is strictly necessary (where they cut you). Apparently French and some Belgian doctors are notorious for this, they just do it as routine, and it is apparently very damaging and heals worse than most tears.

Wish you the best of luck and can only urge you to be as informe d as possible, get your obstetrician on your side and consider another hospital if they are really pushy about these issues...

[bctmum]

Talk through your concerns at your bct classes.

Belgium is a great place to have a baby. I'm surprised St. Luc don't do mobile epidurals as they're one of the big hospitals.

Get a physio to help you through labour - a wonderful system. Ask your doc for some names. You'll do classes with the physio & they'll get you in the best labour position, do massage & help you. A bit like a doula I think.

Write a birth plan saying what you want & don't want. Your doc should agree to your wishes. Many local mums are happy with whats on offer so your doc will probably just assume you are the same. You should be able to use any birth position youy want. If it's only a birth table for delivery ask if they have a birth chair?

If necessary change hospital - do a tour at Braine l'alleud - a great hospital that encourages 'natural birth' If you have to chgange doc then call Braine to make an appointment with any gyn/obs doc.

Can vouch for natural birth here - with non of the worries you have described.

all the best

[Gemmitygem]

bct mum: I'm sure you're right about them 'letting' you do it the way you want: I'm just nervous in case I can't get my wishes across and am forced to do certain things, undergo certain procedures etc... UZA in Antwerp does seem to be quite patient centered, but they don't let midwives deliver the baby etc, instead the obstretrician enters in a blaze of glory at the end: I'm a first timer so don't know what to expect but just want to fend off various horrible interventions!

[bctmum]

GGem - I don't know your hospital but would say that you should talk it through with your doc.

Midwives from the hospital don't deliver the baby but somehospitals allow independent midwives to deliver the baby. Ask them about this.

Also for the episiotomy tell your doc you don't want one. All the procedures just refuse them. The midwives will just note down you said no. Tell your doc in advance of this.

Do you have a physio - they're great for helping a natural labour & birth by keeping you upright & moving.

It's really a case of talking to the staff so that they understand what you want. The locals may just go along with the care offered & you might be routinely offered procedures etc that you don't want - as soon as they know you have your own ideas they should respect them.

Write a birth plan in flemish & hand it over to the staff - get your doc to put one in the notes. Get your partner to be confident to express what you want if you're unable to do so.

Have you called the bct info service to see if anyone has delivered in your hospital or had the care of your doc? Someone may have offered to talk to other mums about their experience. Also talk to the bct antwerp group about your doc & hospital.

I was stressed about my first being born here - but afterwards I was so pleased to have got through it & everything ok & my wishes respected.

Hope things go well for you - hoping to hear your good news soon.

[Gemmitygem]

thanks!

Actually I was in contact with the bct and with the antwerp MOMs, and they gave me really good advice (and in fact that's why I chose UZA, because someone from there said it was very mother-centred and in that sense like the UK, with the better care you get in Belgium..

My obs is very nice and said she wouldn't do a routine epi but couldn't guarantee it if a colleague was on duty, so it's written on my notes, but I'm just nervy in case on the day I can't get my wishes across..

would like to get a physio (kine), but don't know how to find one, and worried it's a bit late now as I'm due in 8 days and don't want the stress of trying to find one..

I'm sure it will all be fine, my DH is bilingual in Flemish etc etc, and the obst is a woman and very sympathetic; anyway will post the gory details at some point on our october thread,

thanks for your response!

[bctmum]

hi ggem - sounds all good.

get your partner to state no routine epi for you - you don't want to be thinking of this.

for the physio call the gne/obs dept and ask who they recommend. Call them & it will be ok even now for them to come to the birth. You could even ask if there is an on call physio at the hospital? don't know if this would be the case but worth checking.

Hope you've packed your bag....

Something else that helped me out was to be sure which entrance was the out of hours /night entrance to the hospital.

[lisa27]

^Women should be informed that eating a low-residue diet during labour (toast, crackers, low-fat cheese) results in larger gastric volumes, but the effect on the risk of aspiration if anaesthesia is required is uncertain."

and "Women should be informed that having isotonic drinks during labour prevents ketosis without a concomitant increase in gastric volume."

Which when translated says what..???!!! Is it just me who didn't really grasp what was being said..? ^

I think this is right...It's basically clinical speak for the contents of your stomach and the risk of it being regurgitated and ending up being inhaled into your lungs as some of the drugs used in anaesthesia relax your muscles - including the ones that keep the gastric contents in!
There's been a bit of debate about eating and drinking in labour in the past...the bit about antacids is to do with not giving them to women routinely - they are used to help dry up gastric nasties to help stop risk of the above if you have to go to theatre.
The bit about ketosis is related to your metabolism and your body breaking down fatty acids and not much carbohydrate. It can happen when the body is starved of food, or in cases of diabetes. Your breath smells sweet like pear drops.
Labour is hard work and you need something to keep you going!
Good luck with getting the birth you want ladies, hope all goes well.
Low alcohol beer sounds interesting!

[bctmum]

The beer comes with the lunch time meal - not everyday though! A change from orange juice

Plus in the hospital restaurants you can get proper beers - even at 10 in the morning (some people are actually supping a beer at this time!)

Plus the hospital food is lovely - I love the waffles and cakes - perfect with a tea or coffee.