Nurse and patient advocate Carolyn Rafferty, RN, BSN, can answer your childbirth questions! Send them to her here.
Carolyn Rafferty, RN, BSN

Your question:
I would like to be able to move around during my labor, but my friends who have given birth recently tell me that the nurse made them get into bed right away. What if the nurse says that I have to stay in bed? Can I refuse to?

The nurse answers:
Many times when you come into a hospital for your labor it is expected by the medical team, your OB, midwife and nurse that your baby will be assessed prior to deciding what next actions are appropriate. This is usual and responsible care. One thing that will most likely be done is that you will be placed on the fetal monitor right away to get an initial tracing. The monitor is the most frequently used method of evaluating how often you are having contractions, how long they last and how the baby is responding to the contractions. This is the most likely cause for you being asked to get into bed right away.

Most hospitals have come to rely heavily on the electronic monitor over hands-on assessment. It probably has to do with wanting a physical tracing to document that everything is okay. Remember, a lot of what happens in obstetrics is based on the medical belief that something might go wrong at any moment rather than the belief that most women can give birth just fine without any intervention. Another motivation for continued electronic fetal monitoring is to have that document for evaluation if there is any question about how your care was managed based on any possible negative outcomes law suits).

That said, if you are experiencing "normal physiological birth," you went into labor on your own and you have no identified high risk factors (high blood pressure, post dates, gestational diabetes, etc.) then once that initial assessment is obtained and the baby and you are thought to be doing well, then you should be able to move around and be monitored intermittently. Some hospitals will use telemetry (a system of wireless monitoring while you move around). Some will use a hand-held doppler to listen periodically. Some will ask you to get back into bed once every hour or so to put you back on the monitor and obtain another electronic assessment of the baby and your contractions.

In health care you always have the right to refuse treatment but it is important that you are informed so that you can be confident you are making good decisions for you and your baby.

If you are being told that everything looks good and that your baby is doing okay with the contractions, then there really isn't any reason you should have to stay in one place and not move around. Many women find freedom of movement necessary to cope with discomforts of labor and women tend to intuitively know what position is best for them.

It is very important that you discuss these types of possible limitations on your labor choices prior to going into labor. It is crucial that you find out your health care provider's philosophy of "normal birth" and remain informed and "on the same page" with him/her throughout your prenatal and childbirth care. If you find you are not "on the same page" with your provider, you always have the right to find a new one. This is your baby, your body and your birth. Be wise, informed, and your own advocate. For further reading on provider relationships please visit www.motherfriendly.org/resources/10Q to read Having a Baby? 10 Questions to Ask.PregnancyAndBaby.com

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