Giving Birth in Austin Texas
Most enquires for my doula services are from first time moms planning an unmedicated birth or moms who previously had a challenging birth and want to stack the odds in their favor of a positive, healthy experience. If you’re planning on having an epidural, it’s unlikely that you’ll have any challenges accessing the tools you need for the kind of birth you’re planning. However, if you’re strongly considering having an unmedicated birth having an understanding of how the odds are not in your favor is a good place to start so we can plan our strategy based on the realities of the current model of care in Austin/Georgetown.
Choosing to have an unmedicated birth is a deeply personal decision, often influenced by a desire for a more natural birthing experience and to avoid potential side effects of pain medications. However, having an unmedicated birth in a hospital setting comes with its own set of unique challenges, especially when faced with understaffing and overburdened staff.
The Reality of Hospital Staffing
One of the primary issues in many hospitals is the lack of sufficient staffing. Labor and Delivery (L&D) units are often busy, and nurses and midwives are tasked with the care of multiple laboring women simultaneously. This often results in moms receiving less personalized attention and support, which is crucial during the intense experience of labor.
Limited support makes an unmedicated birth more difficult.
Experiences As a Doula in Austin
My experiences as a doula in Austin,Round Rock and Georgetown highlight these challenges vividly. During unmedicated births, parents had to contend with the reality of an overstretched L&D unit. Over the course of labor, I’ve often had up to four different nurses providing clinical care to my clients, each of whom was responsible for multiple moms and babies. This rotation of caregivers, coupled with the high patient-to-nurse ratio, meant that we rarely had a nurse present in the room for more than ten minutes at a time. Imagine you’re a first time mom planning an unmedicated birth with very limited support. Partners can learn lots of ways to support you but they don’t have the insights into the local birth scene in a way that doulas do and they’ve never given birth…
The only times a nurse was consistently available were for routine procedures: placing and removing the monitor, and checking blood pressure and vaginal examinations. I estimated it to be about 10 -15 minutes of support by staff for every hour of labor.
How Does Your Hospital Stack Up?
The latest data on how local hospitals are performing is now available. (July 2024)
St. David’s North Austin has made no progress in staffing ratios (Approx 9500 births per year).
26% cesarean rate
St. David’s Round Rock also has concerning staffing levels. (Approx 1500 births per year)
< 23% cesarean rate
St. David’s Georgetown
St. David’s Georgetown is a much smaller unit with about 1100 births per year.
< 23% cesarean rate
The Impact of Limited Support
The lack of continuous support can have a significant impact on your birth experience. Unmedicated births often require more hands-on support, with moms relying on physical and emotional support to manage pain and stress naturally. In a well-supported unmedicated birth, nurses or midwives can offer techniques such as massage, guided breathing, and other comfort measures that help the laboring woman cope with pain and progress through labor.
However, in an understaffed environment, these forms of support are difficult to provide. This can leave mothers feeling isolated and overwhelmed, potentially prolonging labor due to increased stress levels, which can, in turn, impact the overall health and well-being of both mom and baby.
Empathy for Nurses and Midwives
It's important to recognize the tremendous strain that nurses and midwives (and many OBs) are under in these situations. Many healthcare professionals are incredibly frustrated by their inability to provide the compassionate, individualized care they know is essential for a positive birthing experience. They are committed and passionate about their work, but systemic issues often limit their capacity to deliver the level of care they aspire to provide.
The United States spends more on maternity care than any other developed country, yet outcomes are some of the worst in the developed world. This paradox highlights the systemic problems within the healthcare system that impact both parents and healthcare providers. Nurses and midwives often find themselves in a position where they must juggle multiple critical tasks and patients, leading to burnout and a sense of helplessness.
The Role of a Doula
For those planning an unmedicated birth in a hospital, hiring a doula can be a game-changer. A doula is a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth.
Benefits of Having a Doula
Continuous Support: Unlike hospital staff who may be responsible for multiple patients, a doula is dedicated solely to the laboring mother. This ensures that the mother receives continuous, one-on-one support throughout labor.
Pain Management Techniques: Doulas are skilled in various comfort measures and pain management techniques such as massage, breathing exercises, and positioning. These techniques can be especially beneficial during an unmedicated birth.
Emotional Support: Labor can be an emotional rollercoaster. A doula provides consistent emotional support, helping to reduce stress and anxiety. This emotional stability can have a positive impact on the progression of labor.
Advocacy: Doulas help to advocate for the mother’s wishes and birth plan. They ensure that the mother’s preferences are communicated clearly to the hospital staff, which can be crucial in a busy and understaffed environment.
Support for Partners: Doulas also support the birthing partner, offering guidance on how they can best assist the laboring mother. This creates a more cohesive support team, enhancing the overall birthing experience.
Strategies for Expectant Mothers
In addition to hiring a doula, here are a few strategies to consider for a more positive unmedicated birth experience in a hospital - if having a doula isn’t an option for you these strategies will be helpful:
Choose a Hospital that provides 1:1 nursing care (this is considered the gold standard). Currently that is available at Moontower Midwifery or Texas Children’s Pavilion for Women Or consider a birth center or homebirth.
Choose a Provider with low induction rates and low cesarean rates for healthy first time moms. Midwife-led care is the gold standard.
Create a Birth Plan: Clearly outline your preferences for an unmedicated birth and discuss these with your healthcare provider in advance. Ensure that your birth plan is also communicated to the nursing staff upon arrival at the hospital by your partner.
Educate Yourself and Your Partner: Attend childbirth classes focused on unmedicated birth techniques. GentleBirth is a great option - we have online and in person classes. Both you and your partner should be familiar with pain management strategies and comfort measures that can be used during labor.
Advocate for Yourself: Don’t hesitate to speak up about your needs and preferences during labor. If you feel you’re not getting enough support, ask for what you need.
Preparing for a Positive Birth
While the challenges of an unmedicated birth in a hospital setting can be daunting, it is possible to have a positive experience with the right preparation, support (and a little luck). Hospitals are increasingly aware of these issues and some are taking steps to improve staffing levels and the quality of care provided to laboring women. An unmedicated birth can be a fulfilling and empowering experience. Understanding and addressing the systemic challenges in maternity care, alongside empathetic support for healthcare providers, can pave the way for better outcomes and experiences for all involved.
If you’re looking for a doula let’s schedule some time for a chat and help yourself to my free resources.
Tracy
