A few weeks ago, I was asked to help teach a class at our local CareNet, which is a Christ-centered crisis pregnancy center. There was two topics for me to teach that night: Creating Your Birth Plan, and Coping Measures During Labor. Tonight, I give you the first section that I wrote. SO much to think about!
Creating Your Birth Plan
What is a birth plan? Put plain and simple, a birth plan is a
way to communicate your wishes to the doctors, nurses, and midwives who
will care for you during labor and delivery. It is not something that is set in stone;
it simply lets them know your preferences. Remember that things can
(and sometimes do) go wrong, and it is important to try and be flexible
when that happens in order to best protect your wellbeing and your
baby’s. It is something that is optional, not required, for you to bring
with you to the hospital. It is best to start writing your plan and
have your preferences figured out BEFORE you go in to labor! If you are
unsure about a certain procedure during labor and delivery, be sure to
ask your midwife or doctor.How do I prepare to write one?
The best way is to do your research before you write one. Ask questions to women you know and trust will give you good advice about child birth. Stay away from seeking opinions from women you know who will only give you horror stories about their birth. Research what interventions are commonly done at hospitals or birthing centers in your area (epidurals, episiotomies, C-sections, forceps, IV accesses, external fetal monitoring, and the like). An intervention is anything that does not occur during natural, healthy delivery. For example, Lawnwood Regional Medical Center has a 44% cesarean section rate, and most area hospitals are close to 100% on the intervention rate: you can't even get away without an IV unless you sign an "Against Medical Advice" (AMA) waiver. Again, if you don’t understand much about a procedure, then ask! Once you understand what an intervention is, what it’s risks or benefits are, and how they affect your labor, you can make a better decision about if it’s right for you and your baby. Also remember to talk with the people you plan on having with you during labor. Your husband or support partner may have opinions about how he or she thinks labor should go. It’s a team effort to have a baby!
What should I include in my plan?
- First, decide where you want to have your baby. A birthing center, a hospital, or a homebirth with a midwife? There are many options to choose from. Take in to consideration your health during pregnancy, as well as the baby’s health.
- Next, you may wish to discuss who you want to be with you for support during your labor. Most hospitals will not limit you as to who you want present during labor and delivery, unless you are in an operating room for a C-section (then it’s one person). Words to the wise- don’t invite more than a couple of people to be with you. It can turn in to a competition for your attention, and take your focus off what you need to accomplish.
- Talk about positions for labor and birth with your midwife or doctor. Would you prefer to be on your side? Walking? Upright with pillows behind you? On a birth ball? Rocking chair? In the shower or tub (my personal favorite)? The possibilities are endless, provided your care provider is on board with you. Your preferences may change depending on how the baby is positioned in the birth canal. Talk with your provider about what options are open to you.
- Discuss the atmosphere you want during labor. Did you know you can bring music with you? Have the lights dim? Do you want to bring your own pillows or blanket for comfort? Do you want to wear your own clothes or a hospital gown? Are you allowed to be mobile, to help speed along delivery? Will you want to incorporate a certain childbirth technique (Bradley, Lamaze, hypnobirth, etc)? Do you wish to be allowed to eat lightly or drink?
- Pain relief is a huge topic. Would you like to have your baby without any pain medication? Do you want to consider IV pain medication, or do you want an epidural? Remember- there are many things to take into consideration regarding the baby and your health if you want to have pain medication. Any pain medication you have WILL be passed to your baby through the placenta. If you plan on breastfeeding, it may affect how awake your baby is and his or her ability to breastfeed during the first few hours.
- Speeding up labor is sometimes necessary if the baby is in distress, but often times used much more casually. Many times a mom will be given Pitocin to speed up her contractions. This can also make labor much more painful, and can cause unnecessary complications due to a doctor being impatient. Be sure to discuss with your doctor or midwife when they would use Pitocin, what the risks and benefits are, and that they are not just using it so they can get home to their families.
- You will most likely have you and your baby’s heart rate monitored during labor. Discuss how you feel about external fetal monitoring, internal fetal monitoring, or Doppler monitoring.
- Discuss how you feel about assistance during pushing- this includes having a forceps delivery (basically using tongs to help pull the head out), an episiotomy (an incision made to the surrounding skin to make it wider for the head), a vacuum delivery (having a vacuum suck the baby’s head out), and other interventions. Research the risks, benefits, and why you would need to have any of these included in birth. Decide whether you would rather allow your self to tear if need be, or to have an episiotomy done.
- Discuss with your provider what positions you will be able to push in. Depending on the provider and the baby's position in the birth canal, having the freedom to push in a position that is not what you see on TV can greatly ease your pushing. Pushing in the water, using a birthing stool, being on your hands and knees, or being upright/semi-squatting with someone to support behind you can all be effective in pushing your baby out.
- Talk about skin to skin contact after birth, whether you have a C-section or vaginal birth. Some providers encourage it, and some you have to ask. It greatly helps to regulate the baby’s body temperature, helps to promote bonding between you and baby, helps to regulate the baby's heart beat after birth, and also helps to stimulate breast milk production. Side note: After my first birth, I was actually chastised by a nurse at the local hospital for skin to skin contact after birth, being told that my baby would end up "sick" if I didn't put some clothes on him. His temperature was perfect (imagine that!) from my body heat and the fuzzy blanket on top of him. Sometimes you do have to educate the health care professionals around you- of course, in a non -confrontational way.
- If you have a C-section, discuss where you would like to have the baby after birth. If the baby is recovering well, would you like to have the baby with you? Or would you prefer to have a family member go with the baby to the nursery?
- Decide what you would like to happen immediately after the birth. Is there a special person you wish to have the honor of cutting the cord? I recommend asking that the cord not be cut until it stops pulsating, so the baby can recieve all of it's blood from the placenta. Do you want to bank any of the baby's cord blood? Speaking of the placenta, do you wish anything to be done to it? Some people wish for it to be discarded, or to take it home and plant it under a tree, or do something else ceremonially with it.
- Make and educated decision about how you wish to feed your baby. There is no right or wrong way to feed your baby, but there are definite benefits to breastfeeding that bottle feeding does not compare with. If you decide to breastfeed, ask for help from the nurses to breastfeed your baby within the baby's first hour of life, if possible. It's called "the golden hour," and babies that are able to latch on in this time period do significantly better.
- Next, talk about whether you want your baby to room in with you or stay in the nursery. Most mothers today wish to keep their babies with them, but if you need some rest, you can ask that the nursery keep your baby and bring him or her to you when the baby is ready to be fed. Keeping baby with you will help cement your bond and kick those maternal instincts in. Don't be afraid to ask for your baby, you worked hard to get them here!
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