5 Things You Didn't Know About Hospital Births

Can you fire your nurse? Do you have to wear a hospital gown during labor? Can you snack during childbirth? Check out these surprising facts about giving birth in a hospital.

Wondering how your labor and delivery will go? If, like most pregnant people, you're planning on a hospital birth, you probably learned some basics in your childbirth class or on your hospital tour. But that doesn't mean the experience won't be without its share of surprises. Here are some things you may not know about giving birth in a hospital to help you prepare for your big day.

You Can Request a Different Nurse

It's true: If you find yourself assigned to a nurse you just don't feel comfortable with, you're under no obligation to keep them as part of your birth team. Of course, it's ideal to give the person a chance, but if it's just not working, you can request a change. You deserve to have people you jibe with and trust in the room when your baby is born.

To make the switch, simply ask to speak to the charge nurse and ask to have a different nurse take over your care. Awkward? Maybe, but it's not unacceptable or rude. Nor is it uncommon. "Women can and do request a different nurse during labor," says Jennifer Williams, a certified nurse-midwife who works in Albuquerque, New Mexico. "Different personalities mesh in different ways." It's your medical care, so honor your needs and instincts.

Related: Anatomy of a Delivery Room

You Don't Have to Wear the Hospital Gown

Many pregnant people wonder if they have to wear a hospital gown during labor. Others simply assume that it's required to don those sometimes stiff and scratchy tie-in-the-back garments. But if you're not into rocking the standard-issue hospital gown, you don't have to.

You might choose to put the gown on anyway because it can be easier, doesn't obstruct your movement or care, and you don't have to worry about cleaning it. However, you can also wear your own clothes instead, if you prefer.

Just make sure the clothing you choose is comfortable, convenient, and can get dirty (or straight-up ruined). Good options include a simple, cheap nightgown or a stretchy or loose tank top. If you like the idea of a hospital gown but want one that's brand new and/or better quality, you can order designer options online. A birthing wrap is another possibility. These wrap-around dresses are designed to offer coverage, comfort, and easy access during labor and delivery.

On the bottom, you can choose to wear comfy pajama bottoms, yoga pants, a stretchy above-the-knee-length skirt, sweatpants, or anything else you like—until they need to come off. Note that many pregnant people end up giving birth naked anyway, so you might not even need or want clothes.

You May Not Be Able to Eat

Many hospitals have a policy that pregnant people can consume only clear liquids during labor, especially if an epidural is planned. This rule made sense back in the day when pregnant people undergoing cesarean delivery were given general anesthesia, which put them at greater risk of aspirating (or breathing in) their own vomit during the surgery.

But today, the vast majority of cesareans are done with epidurals or spinal blocks, and the expecting parent is awake and alert the entire time. Having any type of anesthesia can potentially cause you to feel nauseated, so there is still a small risk of aspiration even with epidurals or spinal blocks, but the risk is relatively small.

In addition, the American Society of Anesthesiologists recently issued a statement urging doctors to allow healthy pregnant people to eat a light meal if they desire. Furthermore, a 2018 meta-analysis, showed that allowing low-risk pregnant people to consume food during childbirth did not increase the risk of complications and may even speed up labor. Still, the restriction commonly persists.

If you're concerned about not having access to nourishment while doing the incredibly physical work of labor, talk to your provider to find out their rules or recommendations about eating during labor, and learn the policy of your intended place to give. Additionally, if you ask to be able to eat, sometimes your requests will be accommodated.

Related: How to Prepare for Your Delivery

You Can Say No—to Practically Anything

Giving birth in a hospital doesn't mean giving up your autonomy and free will. Every aspect of the care you experience requires informed consent from you and/or your partner or support person. This means you can say no, ask for something different, or request to have some time to decide about practically anything, including common policies and obstetric procedures like induction, amniotomy (breaking your water), birthing positions, having a medical or nursing student in the room during labor or birth; and vaginal exams.

Remember that, by and large, your medical providers have your best interests at heart and their recommendations are sound. However, just because something is done routinely, doesn't always mean it is necessary or of benefit in your specific case.

In fact, according to the American College of Obstetricians and Gynecologists (ACOG), "Many common obstetric practices are of limited or uncertain benefit for low-risk women in spontaneous labor." Instead, the ACOG recommends collaborative decision-making between the pregnant person and their doctor and a family-centered approach that honors the pregnant person's wishes as much as possible. That said, it's vital to work with a medical provider you trust.

Related: The Best Exercises to Prepare for Labor and Childbirth

"Remember that you have rights as a patient and that you make decisions for you and your baby," points out Shelly Lopez-Gray, a certified registered nurse in Houston and creator of the Adventures of a Labor Nurse blog. If you've made a birth plan, this can provide a template for your wishes and decisions.

Of course, if you decide to say no to something, that doesn't mean your refusal will be easy to deliver—or accept. Be prepared for possible pushback after saying no, particularly in the case of a substantial medical concern or life-threatening emergency. Aim to weigh your doctor's concerns carefully. Ideally, create a birth plan and talk to your provider before delivery day about potential points of contention so you're on the same page before you head into the hospital. The earlier in your pregnancy you discuss your birth wishes, the better.

"Battling hospital policy during labor would be a distressing use of energy that is needed to birth," says Williams. "For peace of mind, try to work out those details before labor. Remember that no one can make you do anything you don't want to do and you're always entitled to ask why for any procedure or policy."

Related: Can I Have a Water Birth in a Hospital?

You May Not Need to Stay the Whole Time

A normal hospital stay is 24 to 48 hours after an uncomplicated vaginal birth, and about 72 hours for a cesarean delivery. But if all is medically well with you and your baby, you can exercise your option to leave a little bit early, if you'd like. Just be aware that some insurance companies will cover only the full stay, so confirm whether leaving early works for you financially.

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