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Tuesday
Apr262011

Touring LDRs Around the Country

It irks me that hospitals spend inordinate amounts of money on the aesthetics of Labor and Delivery Suites. Several million dollar renovations create identical rooms around the United States. And, as far as I can see, every single one is geared towards making things easier for the hospital staff, not the laboring woman herself. Women do not have homebirths because the hospital room doesn’t have pastel wallpaper or integrated technology; women have homebirths because they want to have a normal birth without everyone around them expecting tragedy. Autonomy + safety would make a fantastic birth room in a hospital.

If I were to design a Labor, Delivery and Recovery room, I would do things a lot differently than they are done now. And, by design, I mean creating an entire ambiance, not just what furniture and curtains would I pick.

But, before I lay my ideas out, let’s look at what hospitals around the country have done with their million dollar renovations. And while I detail Medical University of South Carolina, I could just have easily used any of the other hospitals mentioned –and dozens more not listed here.

Medical University of South Carolina has several videos that describe their services to women, a pregnant woman walking with the Nurse Manager of the unit, learning about her upcoming birth as we watch and listen in. When “wood” floors are highlighted as making the unit more home-like, I chuckle because how many people really do have wood floors? And who really cares what the floor looks like as long as the darned thing is clean!

Televisions and free Wi-Fi are there for both mom (“When you get your epidural.” Not if; when.) and dad, “So he can watch USC football games.”

The nurse states, “You’re put in a hospital gown when you come in,” and that the “Backs are open so we can put in your epidural.” It’s rather disgusting that an epidural has become the default.

When speaking about the fetal heart monitor, she says, “The straps stay on the entire time.” No intermittent monitoring here.

MUSC allows video and still cameras, but during the actual delivery, the photographer is required to move to the head of the bed and take photos from that position. The nurse says that it’s more discreet. No mention was made that not seeing every detail of the birth removes the possibility of visible proof in a court case of the doctor’s or midwife’s hand movements, say, in a shoulder dystocia, for example. While this limitation is annoying all on its own, it is far more liberal than a growing number of hospitals out and out banning all cameras during the delivery and for the first few minutes afterwards. I haven’t heard a woman say she was birthing at home in order to have total control over the photo documentation of her baby’s birth, but I am sure that, in the future, this aspect will become one of the top unhealth-related reasons to stay home. I find it beyond insulting and disrespectful to control what a family is able to –and not able to- record during their births. I can’t help wondering… if someone refuses to stop filming, what would the staff do? Knock the camera out of their hands? Who pays the staff anyway? That the staff’s fear of proof in lawsuits demands the families become accomplices in their protection is really gross.

MUSC’s really special LDR room includes:

  • The typical OB hospital bed that breaks down into the ideal configuration for the doctor. Not the mom, but the doctor or midwife. The woman’s comfort is secondary. Perhaps even tertiary since the nurses have great access to the birthing woman, too.
  • The bed’s mattress softens or hardens depending on mom’s wishes. The nurse in the video makes the comment about women lying in bed, hour after hour, needing a variety of firmnesses in a mattress.
  • The bed has foot pedals (again, this was highlighted as something unique to MUSC) for the mom to use as she pushes. Foot pedals are often left unused in the births I've seen as, instead, the calf is “supported” in a feet-in-stirrups sort of position.
  • The bed also has handles for moms to pull on while pushing. Apparently someone will be shoving her legs back while she yanks on the handles instead of the mom pulling her legs back herself.
  • A removable birth bar was shown in the video and the nurse semi-demonstrated, on the floor, how a woman would sit up to squat and then lie back inbetween contractions. It would be great if the birth bars were used a lot, but with an epidural rate over 60% in most hospitals, that’s unlikely.
  • A birth ball was mentioned as well as saying women can be mobile until they have “their” epidural. Later, the nurse says even women with “their” epidurals are mobile, being turned side to side every hour or so. Now, that’s mobile!

The videos continue saying that after the birth, the baby is put on mom’s belly and she can “help dry the baby off,” then, the nurse says, “We take the baby from you,” and put “Medications mandated by law” into the baby’s eyes (Erythromycin) and, via injection, into the baby’s thigh (Vitamin K). She also talks about the baby getting circumcised the day after the birth as if that was as normal as talking about the importance of a car seat.

The woman “touring” the L&D floor carries around her Birth Plan and asks questions from her paper. The nurse, more than once, says women who have a “reasonable birth plan” can have a “unique birth experience." I suspect a reasonable birth plan doesn't equal a unique birth, but a birth that taxes the nurses least and causes the fewest amount of waves with Standard Operating Procedures.

Each hospital’s website I visited said they had virtually the same “amenities” as MUSC, so I took to reading what they had to say to try and make their units unique in the eyes of the Consumer.

The University of California, Los Angeles Hospital’s Labor & Delivery description says:

“The young couple visits the spacious and light-filled labor and delivery rooms, which include private bathrooms, sweeping views of Westwood, flat-screen televisions, XM satellite radio, sofa beds for dads and families to sleep over, and warming beds for the new babies.”

Let’s look at that in regular-people-speak. The parents… er… mother-to-be and support person? Who says they are young couple? More than likely, they are not young in today’s world. (Nit-picky, I know, but if they’re trying to be inclusive, they should try and be inclusive!)

Next is the private bathroom. Seriously? This is an amenity? I know some older, unrehab’d hospitals still share bathrooms between two laboring women, but that is not the norm around here anymore.

The sweeping views of Westwood are unique to UCLA Hospital, unless the views are less than stellar.

Flat screen TV’s? Eh, pretty common now.

XM satellite radio is an amenity I haven’t heard of before and I think that would be really great! I like when families have their own Labor mix on their iPods, but if the hospital doesn’t have a docking station and speakers, only the mom hears the music unless the family lugs that stuff in. Of course, she is the important one, but I love hearing what people choose for their births, too.

On to the sofa beds… hrm… I’d love to see what they look like. Most "beds" come from the pull-out chairs. They say the sofa beds are for families to sleep over… does that mean the new baby’s siblings, too? If so, that’s a pretty nifty amenity.

And then there’s the “warming beds for the new babies.” sigh No, no, no! Why would the baby warmer be an amenity? It isn’t some bonus for the parents; it’s specifically for the medical personnel! I think if they said there were no warmers, that would be an amenity.

White Plains Hospital, in White Plains, New York, boasts:

“The new Labor and Delivery suites at WPH feature all the comforts of home while still providing advanced medical care. These spacious, state-of-the-art suites are equipped with the latest technology, including a Central Fetal Monitoring System, tastefully tucked behind built-in maple cabinetry and ceiling panels. There is ample room for visitors (two people maximum at one time) and in-room sleeping accommodations for fathers or labor support persons. Each room also has a private bathroom with a shower.”

“All the comforts of home.” The home-like aspect is a common selling point with all these hospitals, but I don’t see any kitchen stocked with healthy food or a king-sized bed so mom’s lover can cuddle with her comfortably. These are comforts, aren’t they?

WPH brags about their “spacious” rooms and there is “ample room for visitors,” but then caveats with “two people maximum at one time”; that’s a serious red flag to me… the limiting of support people. I don’t have rules in my house limiting the number of visitors; do you?

And one of the most irritating –and common- highlights is the technology “tucked behind built-in maple cabinetry and ceiling panels.” C’mon. The moment a woman is admitted, the “cabinetry” is opened (if it was ever closed in the first place) and never closes again. I honestly believe the only time it’s closed is for a hospital tour. Nurses? Is this so? Have any of you ever had patients and had the cabinetry closed?

St. Luke’s Hospital, Kansas City, Missouri says they have “an improved layout (that) was designed with input from physicians and labor and delivery staff.” Wow! No help from the women themselves? Oh, that’s right, LDR’s are designed with the staff’s comfort in mind; women are ancillary.

Shady Grove Adventist Hospital in Rockville, Maryland says, “We talked with hundreds of moms, dads, doctors and nurses to find out what they wanted from their birth experience. The result: state-of-the-art maternity services and the warm, relaxing atmosphere of home. Our birth suites are designed to cater to your every need.”  They then expound on their “Private Mother-Baby Suites”... are the private suites different than the regular birth suites? I read through several times trying to figure out if they were the same or if the private rooms were for women with the bucks to buy them. I think they’re all the same.

The service that especially caught my eye was “a family lounge featuring a kitchenette, a flat screen tv, computers with Internet access and plenty of space for growing families.” At first it seemed each room had that, but as I read more, it really is a central waiting room that has the kitchenette. And I was so excited to share a hospital that came close to a real home-like environment!

Note this new advantage to SGAH:  "A new unit floor-plan that allows nurses to be more accessible 24/7 to meet your every need.” Really? I would hate to have been a patient before that had time periods without nurses. And you know what I want to say about “every need,” right? “Please do not ask me the Pain Scale. Please do not offer medications. Please take this monitor off so I can ambulate. Please cap off this IV so I can get in the shower.” These are my needs; what are yours? One final note about SGAH… they have “48 all private Mother-Baby Suites.” FORTY-EIGHT. Criminy, that’s a huge hospital.

I saved the best for last. In the name of worst Mother-Baby services, Brookdale University Hospital and Medical Center in New York City, wins, hands-down. I’m sure you know a worse one still; please share. Be sure to visit this site and look at the pictures of their “suites.” Note the technology “tucked away” behind the faux wood paneling; it isn’t like that in labor. These labor rooms look a hair’s breadth away from operating rooms because they display the beds completely flat. If I were the person-in-charge of choreographing these photos, I would put a lovely pregnant model in the bed, perhaps cross-legged, perhaps with the birthing bar on the bed. While I know most women are choosing epidurals, the fact that they have the beds empty and flat, connotes the helplessness and vulnerability of women in labor. Blech.

This is the blurb BUH has on its site: 

In Labor and Delivery, and later on the maternity floor, you'll find yourself surrounded by warm pastel colors, soft lighting and floral fabrics. Immediately after birth a few important procedures are performed on your baby. The staff will remove the mucus from your baby's nose, warm your baby, and conduct a physical assessment. After these brief steps are taken, you, your support person and your baby are free to spend ample time together in the LDR room immediately after birth. Mothers who choose to breastfeed are encouraged to begin at this point. Once you are ready to be admitted to your room, your baby will be taken to the nursery.

This video from BabyCenter demonstrates exactly what BUH’s policy is with newborns. It will be at least five minutes before mom gets her own baby. And note that dad is standing behind all the nurses; what’s the woman’s view of her newborn?

With my mouth hanging open in shock, the only positive thing I can say about BUH’s blurb is, “At least they’re honest!” They say you’ll be enveloped in warm, pastel colors, showered with soft lighting and decorated with floral fabrics, but the hell if you get to touch your own baby until they’ve done what they have to do. They’re going to shove rubber into your baby’s mouth and into her nose, hindering that breastfeeding experience you’re so hoping to have. They’ll warm your baby… wayyyy over there in the “special” warming bed amenity so many hospitals brag about. You can watch –if no one’s in the way. They’re going to do their physical assessments on the baby… the one and five minute Apgars… the Dubowitz and/or Ballard, which takes even longer depending on who’s doing the exam… putting Erythromycin in the baby’s eyes and giving the baby the Vitamin K injection. After all that, then you can begin breastfeeding. But, wait! Don’t get too attached. As soon as you’re moved to your postpartum room, the baby goes to the Newborn Nursery. Nothing is mentioned as to the reasoning for this. There is no reason with a normal, healthy baby.

As I poked around, looking at different hospitals around the United States, I found it interesting how each tried to make themselves stand out and how the great majority of them were exactly the same… physically, anyway. It astounds me how hospitals believe it is the accoutrements that will bring clients (patients) in… and might even cause a potential homebirthing woman to change her mind. Really?

In the next post, I’m going to design what I think would be an ideal LDRP room. If forced to, I’ll create an LDR, but then would send moms home 4-6 hours after the birth.

Off to design a great hospital LDRP!

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    - navelgazing midwife blog - touring ldrs around the country

Reader Comments (28)

What a great idea for a post! I can't wait to read about your LDRP design!!! I know some baby nurses who keep newborns on the warmer (WAY on the other side of the room!) from 1 to 35 minutes of age! That's a heck of a long time!!!!! Especially since babies go to the nursery at two hours of age for their bath. Some things are so backwards. I don't "take the baby" to the warmer until at least 5 minutes... (I really HATE having to do this!) By then, mom is usually ok with it (while she's getting sutured/cleaned up) and then my goal is to hand the baby back (skin to skin!) by 13 minutes of age. I do footprints, ID bands, weight, Vit K, Erythromycin, a quick head to toe assessment, ballard, and measurements... all in 6-7 minutes, with Dad at the bedside talking to, photographing, and touching his baby. It disgusts me that some nurses take as long as they do (they do all their charting at the same time as their hands on care).

So many things that need to change!

April 27, 2011 | Unregistered CommenterSigrid

It isn't always like this. I've had 3 hospital births with a CNM and I've only seen the medical equipment cabinets opened once. I was monitored intermittently and with telemetry monitors that let me move around. This last birth, my baby was in my arms immediately and never left them (possibly I let my partner hold him a few times). I gave him a bath myself the next day and went with him for his hearing test (the one in hospital test we didn't decline). I was high risk and my births have all been necessary inductions, so I'm not a homebirth candidate, but hospitals can handle that circumstance well. I guess I didn't know my experience was that rare, but I'm glad I birthed where I did.

April 27, 2011 | Unregistered Commenterb

It was, indeed, rare. Very rare.

April 27, 2011 | Registered CommenterNavelgazing Midwife

This is a great breakdown of the typical LDR suite. The one I gave birth to my son in was identical all the way down to the Wood cabinets to tuck away the technical stuff.

I am happy to say, that despite all of that, I was able to have the labor and delivery that I had hoped for. I labored at home until the contractions were 5 minutes apart (would have stayed home longer but it started to snow), no IV, intermittent monitoring (3 min every 60 min), the nursing staff left me alone unless I pushed the button, no lithotomy pushing, immediate skin to skin after birth, almost immediate breastfeeding and no shots or eye ointment. The only thing I regret is letting them talk me into giving him a bath when he was about 4 hours old because right after his bath he began to have retractions when he took a breath and his O2 sats dropped so he ending up in the NICU for 5 days.

I was able to have the experience I wanted because I choose a physician that was supportive of my choices in both word and deed. I had considered a home birth but finding the right doctor allowed me to have a very comfortable and satisfying hospital birth. Maybe I just got lucky but I think that it was important that I was educated about my choices, willing to stand firm even in the midst of labor, had a wonderfully supportive spouse and an equally supportive care provider.

That said, I cannot wait to see your vision of the perfect LDRP suite.

April 27, 2011 | Unregistered CommenterKela

I have never given birth, but was present at my sister's most recent hospital birth experience. I was shocked at how long she had to wait to hold her new baby!

It was then that I realized I wanted a vastly different experience. it reminded me of the opening of Monty Python's meaning of life. (they even had the little machine that went ping!).

April 27, 2011 | Unregistered CommenterLauren

Don't forget the twinkle lights! Because everyone knows that is only reason people are choosing homebirth and will certainly decide to birth at a hospital if there are twinkle lights involved!!

April 27, 2011 | Unregistered CommenterVanessa

This is a great post. What's interesting is that, even for hospitals where more gentle birthing processes ARE available, they certainly aren't advertising this widely. With an increasingly savvy customer base, you'd think they'd WANT to let expectant parents know when and where birthing outside the box is available. Can you imagine a hospital including statements like these in their promotional materials: "We welcome and encourage doula care," "Intermittent monitoring via hand held doppler is practiced," "Birthing balls, ceiling-mounted ropes, robozos and birthing tubs are available in each room," and "Upright birthing positions are encouraged as much as possible," ?

April 27, 2011 | Unregistered CommenterKimmelin Hull

Great post Barb. After reading this I couldn't help but look up the hospital where I had my two kids. This particular hospital catered to low-risk cases (no NICU), and I'd rate it as decently supportive of drug-free birth and excellent for mom-baby care. And yet the website is STILL filled with cringe-inducing descriptions of LDRP. My favorite was on the virtual tour they boast that "Our nursery is state of the art for your little one." Not only does the picture clearly show NO infants in the nursery, in my four visits up there (tour, two kids, pick-up a lost item) I never once saw an infant in the nursery, because babies stay in Mom's room at all times except on parental request. You'd think this would be a selling point! In fact, when we were doing the tour I considered it a good sign that rooming in was policy taken seriously.

You might be interested their "Maternity Guide" book given out by providers in the first trimester. You can sort of sense the tension between trying to support patients' choice (including the divergent desires between the natural birth folks and the epi-me-in-the-eighth-month folks) versus hospital routinization.

http://www.legacyhealth.org/body.cfm?id=1357

April 27, 2011 | Unregistered CommenterNoelle L.

I think it's interesting how a lot of places advertise private rooms. I have attended births at a range of public/private, smaller/larger hospitals (never really any small community hospitals though, always in cities) and I have NEVER seen anything but private rooms in L&D and in postpartum. (Even at the public hospital where the L&D room was the size of a broom closet.) How common are shared rooms these days really? Even in postpartum? It just seems like such an advertising gimmick at this point to make moms imagine that they're getting some kind of special experience when it's really the standard (as you've pointed out with all these other "amenities"!)

April 27, 2011 | Unregistered CommenterRebecca

b, curious as to where you birthed. I also had a great hospital experience with a CNM here:

http://www.atlantichealth.org/morristown/our+services/maternity

Pretty good description. I think coming in with a midwife doesn't hurt either. That said, I'm sure if you came in with a intervention-happy OB, all the great hospital stuff is moot. As evidenced by this hospitals c section rate (42%), which is better than many other hospitals in the area but still way too high.

Even though we had a great experience, we will be shooting for a home birth if/when there's a #2. Staying in a hospital sucks. Even if they are totally supportive of physiological birth in L&D, you are still going to have to sleep on a crappy bed, partner on the couch, being woken up for vitals just after everyone has gotten back to sleep. Boo.

April 27, 2011 | Unregistered CommenterLindsayLB

Can I make a few requests? Not that you wouldn't think of it anyway, but I'm still irked over the design of the room my daughter was delivered in.

Please make the resus equipment mobile and the bed big enough, not just to labor/birth on (if desired), but also to keep the baby's cord intact if resus is necessary.

At the same time, please tuck the bed in the corner somewhere so it's not the focal point of the room immediately, and provide other furnishings that encourage women to stay off their backs. For example, add a soft corner for on-the-floor comfort for those who don't want to be in the bed.

Please make the doors self-closing so that the sound-proofing of the rooms is functioning even if a certain staff member 'forgets' to close the door repeatedly.

Please ban the TV to make people to engage with the process. Please remove the flashing red clock.

April 27, 2011 | Unregistered CommenterVW

I kind of want to cry.

My very best friend in the whole world gave birth about a month ago at Shady Grove, with the only hospital-based midwife practice in the (very wealthy, populous) county. She had seen BOBB, took it to heart, and wasn't that enough for me? I didn't want to push her.

"I think who you give birth with matters more than where you give birth."

I was as supportive as humanly possible and just bit my radical tongue until it bled.

They started her on pit within literally 4 hours of her arrival after PROM. Despite regular contractions. She ended up with a C/S.

Fuck wood paneling.

April 27, 2011 | Unregistered CommenterDreamy

And yes, it just reveals how deep the disconnect is. Docs really think women want homebirths because they get to light scented candles.

Fuck a scented candle.

Can you tell I'm in a mood?

April 27, 2011 | Unregistered CommenterDreamy

Barb, what is saddest is that most women that I take care of would be thrilled with these units. They WANT an epidural. They do not want their baby right away. Breastfeeding--ugh. In my rural area less than 10% of women want anything to do with the kind of birth you and I value. Hospitals spend millions on these places because that's what the customer wants. Really.

April 27, 2011 | Unregistered CommenterMadonna Lactans

Then they need to quit talking about this or that being home-like!!

All of y'all are great. And yes, my "own" LDRP incorporates some of the things you're mentioning. I'm writing!

April 27, 2011 | Registered CommenterNavelgazing Midwife

Here's another one:

Brookwood Medical Center, Birmingham, AL

http://www.bwmc.com/en-US/ourServices/medicalServices/Pages/Women%27sMedicalCenterAddition.aspx

They are about to open a new women's center. They actually have a bullet point that says, "•Natural child birthing amenities, including a dedicated Waterbirthing suite" At least they say that, along with many of the other points you mentioned. They also have one-on-one nursing care (I recently helped a friend when she gave birth there), but they have around a 40% c-section rate. They don't mention it on the site page, but they promote immediate skin-to-skin after birth for the first hour or so, and do all assessments, tests, shots, etc., after that time, and up in post-partum if the mother wants to wait. Anyway, thanks for this post...it got me thinking...and I too am curious to see what your ideal is. :)

April 27, 2011 | Unregistered CommenterBecky

Barb, your review of the LDR's is excellent, thanks. I find it fascinating that even in so called home like environments, the machine that delivers the epidural concoction and the machine that goes 'ping' aka 'monitor' or fetal surveillance unit are on full display, just in case any woman wondered what world she was entering...

April 28, 2011 | Unregistered CommenterCarolyn Hastie

A few things I wanted in my room, a place where I could go alone...sometimes that's the shower, but I don't know, a quiet corner? I'd do that at home, go to my room, or maybe walk outside. Yes, a place to walk outside if the weather is nice night or day...a safe place. A step stool seemed to be something I wanted last time. I kept thinking it would be nice to have one foot on it while I leaned on the bed. A real couch for people to sit on (including me). Something to keep the chux on the birth ball, and to keep it from rolling off or over when I get up and down. A ballet barre attached to the wall to use for squatting and such (minus the wall mirror). Always nursing friendly tops if I wear the gown. Robes if I wear the gown...for earlier labor. Food station, yes, in the room not down the hallway. I almost want to wear a hydration pack if I ever labor again, they cannot take it away. Pillows in all sorts of shapes for position changes. Warm floors, but always a fan if needed too.

April 28, 2011 | Unregistered CommenterDawn

Here are some of the things that seem to matter and don't to most of my clients:

Want: A birth swing or sling
Don't Want: continuos monitors, (reg. and telemetry) esp. ones that don't work!!!!! If you're gonna use these do they have to be BIG, confining and completely non conforming to the pregnant female form. Come on!

Want: Nice BIG birth tubs/jacuzzis.
Don't Want: tiny showers that have sh** pilled in them, or Jacuzzi's that are WAY down the hall in triage.

Want: Good food
Don't want: Routine IV's

Want: Birth stools
Don't Want: sucky triage rooms. Just get rid of those fu***ers.

Want: Heating pads that conform to the body
Don't want: Thin scratchy blankets. Don't you think that moms and dad to be deserve nice blankets!!

Want: Pillows and big beds
Don't Want: well, little tiny beds that I have found good for one thing. Stitches, for wounds caused from pushing a mom's legs to her ears and increasing the pressure on her perineum.

That is what I can think of off the top of my head...

April 28, 2011 | Unregistered CommenterCrowbabies

I'm sure there are some things at "my" hospital that could be changed for the better, but I really wanted you to see how my local hospital's birth center (yes, together but separate) is "advertised" on their website. I would love to hear your thoughts on this video!!

http://www.sjws.net/health-services/womens-services/midwives.htm

I gave birth in a waterbirth-tub-equipped suite, would describe my birth as happy and memorable, and will absolutely give birth next time in their birth center.

April 28, 2011 | Unregistered CommenterSara

Oh my good gravy I just noticed how poorly produced that video is. If you skip ahead to the 7 minute mark the audio and video resume, but not together. Sorry.

April 28, 2011 | Unregistered CommenterSara

I'm going to go against the grain on one little thing. Keep the TVs. When you get induced, you might be at the hospital for a long time. It gets boring. We watched "The Jerk" while the Cervadil did its thing. It helped take my mind off how upset I was to be getting induced. Nothing wrong with that. (And hey, most of our homes have TVs in them too.)

April 29, 2011 | Unregistered Commenterchingona

I gave birth in a hospital much like you describe above so I just wanted to chime in on what the nurses did for us. First of all I was the weird one on the tour when we came to visit the L&D wing asking about the tub they have (which I am betting they never use since you have to be continuously monitored in there and its a seperate room - also their epi rate at this hospital is like 90%), intermitent monitoring, one to one care ratios etc.

One of the goofy dads on the tour was worried about what would happen when the L & D floor was full (which they told him had never happened). I kept joking to my husband did he think his wife would have to go back out to the parking lot and give birth in the car? I am sure they would just convert a PP room! Hilarious (the dad asked this question at least three times at different points on the tour).

Our hospital also had the cherry cabinets, tv (we never turned it on) and actually a large shower (sadly I did not get to use it during labor). They did have waterproof and wireless external monitors available but there was a limited qty of them on the floor. Our nurses did keep the cabinets closed even when they got their birthing kits out they shut everything back up and kept the medical supplies under drapes so we didn't have to focus on them.

I do remember when I first got admited the first nurse we had (I was there laboring for 36 hours I had an induction for post dates) gave me some speil about the ugly painting across from the bed which was a garden path. She told me I could visualize walking down the path to meet my baby - like my labor (!). We were not a big fan of this nurse - she called my tattoo that had been drawn by my artist husband a "tramp stamp." Seriously. No apology when I explained to her that it was very meaningful to me. Fortunately the shift change happened about an hour after I got admitted - I would have kicked her out if we had her for longer than that.

I spent a few hours after delivery (via csection due to slightly transverse positioning) in the L & D room again because they were waiting for a PP room to open up. I actually really liked having the wood floors and dark wood in there - it was way more welcoming than the cinderblock/vinyl tiles in the PP ward (which had not been renovated in probably 25 years.). But ultimately, it really didn't matter, and despite things not going the way I hoped for, we had a good experience with this hospital.

April 30, 2011 | Unregistered CommenterAllison

I had a transfer to hospital and laboured for 12 hours before ending with a caesarean. I didn't really care about the labour room, except that the hot water wasn't hot enough. It was the week afterwards that really sucked. Shared rooms with staff (cleaners etc) wandering in day and night so you never got any sleep, such strict visiting hours for your partner that you were exhausted doing all the baby care yourself (because the staff were run off their feet), and beds that were hard to get in and out of after a caesar! So forget the labour room - I want a recovery room with a double bed, a hammock for the bub rather than the silly plastic bath-cribs, decent showers with really hot water, and a sign that says "clean later please" so that you can get some sleep!!!!

May 2, 2011 | Unregistered CommenterCarolyn

I gave birth so quickly in the hospital that I didn't even notice the room- couldn't have told you anything about it. I ended up being angry for being charged 2500$ for a room that I was in for 1 hour total.

A year later when I was attending my first birth as a doula I realized how fortunate I was to not even use the "luxury" LDR suite. Stupid wood panelling, stupid monitors, stupid hospital bed...etc.

Dreamy, I'm right there with you. I tried to be as supportive as I could, but my client got an epidural at 7 cm and involuntarily pushing and ended up with a c-section 12 hours later. sigh. No amount of wood panelling a birthing room makes.

May 12, 2011 | Unregistered Commentersara

I doula'd (is that a word?) at a birth at the UCLA medical center a few months back. The shower was nicer than most of the ones I've seen at hospitals around here, bigger with a nice bench to rest on. Most importantly, the CNM staff actually encouraged the mom to use it! Attitude is so much more important than set dressing...and you see the results in their epidural and c-section rates being much lower than average for the area.

The views of Westwood as the sun was coming up were quite pretty too :)

May 12, 2011 | Unregistered CommenterLyssa Kaehler

I gave birth with the CNMs without any medication/augmentation at UCLA Westwood (like 6 weeks after the new Ronald Reagan Hospital opened), and thought it was great. If I had any complaints about the setup, it was that they only had showers, no tubs. I spent a lot of time in the shower dring my 28.5-hour labor, and it helped a great deal, but I remember needing to get the weight off of my lower half during contractions after a while and my arms were getting really, really tired from holding myself up using the handicapped bars in the shower.

They did intermittent monitoring with dopplers inside and out of the shower, and were really respectful of my desire to birth without medication from the minute I walked in. (In fact, I don't even recall the subject coming up -- I never had to "announce" it to anyone).

Overall, the nurses were great. During labor, I walked the halls, and stopped and chatted at the nurses station in between contractions. Silly me, I asked if I was the only one laboring on the floor at one point, since it was a ghost town except for the nurses at the nurses station, and they said no, they were full, but everyone else had an epi and was probably sleeping. (FWIW, I was the only one laboring with the midwives that night).

May 18, 2011 | Unregistered Commentericedancer

Shady Grove in Rockville, MD
I had my 3rd baby here. I am not surprised to see it here in this list.
besides the fact that the state of Maryland ranks in the bottom of Mother- friendly hospitals, In 2009 when I delivered my 3rd baby with midwives, it was the worst birth experience I had. I felt a lack of respect from the Labor and Delivery nurses towards me, and towards the midwives. I feel the best reason not to choose to give birth there has nothing to do with whether or not they have private rooms, or state of the art facilities, but rather the AWFUL negative vibe felt between the hospital staff and women's providers. Hello?! where was the teamwork?
For and area known for it's affluence and education, I felt the hospital staff were undereducated in regards to breastfeeding and other mother-baby friendly care. After having delivered previously at another area "baby factory" also without M/B friendly practices, I felt like I was choosing a "better" option. Little did I know.

May 29, 2011 | Unregistered CommenterLisa

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