Your Biggest Pregnancy Ultrasound Fears (and How They Stack Up Against Reality)
I remember my first pregnancy ultrasound like it happened yesterday. There I was, sitting…
November 24, 2020As a midwife, I love catching squishy babies in unmedicated tub births. There is nothing better than the moment when a baby gently enters the world in a warm tub and doesn’t quite realize that they’ve been born yet. However, I also believe in supporting families and meeting people where they are. That’s why creating a birth plan is such a crucial part of your pregnancy.
Putting together a birth plan as a first-time mother can be overwhelming when you don’t even know what choices you have to start. By reviewing your options, it empowers you to choose what works best for your family.
A birth plan should begin by helping you understand what your options are for birth and opening the door to a dialogue with your healthcare provider. Typically, you focus on the more natural side of birth and then venture into birth preferences if it switches gears into a delivery that requires more interventions than expected. Unexpected situations often crop up during labor!
If any of these conversations with your healthcare provider result in red flags, it’s okay to move on to someone you feel will better support your wishes. Your clinician can be the most critical difference between an empowered or traumatic birth. Many pregnant people opt for a midwife to offer a more holistic touch to their pregnancy.
Since kindergarten, we’ve been using the five w’s to identify the background of any newsworthy circumstance. While life is marked with spectacular milestones, this is one of the monumental ones!
While some want to be surrounded by all of their loved ones, many prefer the intimate environment of just their partner and perhaps one other essential support person. In a perfect world, your chosen support partner would know just what to do. If you want to birth in a hospital, nurses are lovely and will be there throughout your hospital stay but doulas are a different animal. A partner has to juggle your existing relationship and a nurse needs to document your medical progress. However, a doula is there to support you throughout your labor and birth.
The American College of Obstetricians and Gynecologists (ACOG) states that women who use a birth doula are more likely to have a positive birth experience (source). You are more likely to have successful unmedicated childbirth with a doula teaching you and your partner ways to manage the contractions and find natural pain relief methods. While being DONA certified is not a requirement, it does ensure a certain level of training.
While many women opt to avoid all medication, there is a range of analgesia (pain medication) throughout labor and birth. The opioid can be infused either intravenously or intramuscularly. Often, these opioids are enough to take the edge off. Some birth settings also offer nitrous oxide as an option to inhale during the challenging parts of your labor. Have you heard of laughing gas? Nitrous oxide is a different mix of the same gases. You apply a mask to your face as long before the peak of a contraction and keep it on your face as you desire and when you remove it. You may feel drowsy, lightheaded, or it will leave your body within 30 seconds.
Epidural anesthesia gives decreased sensation and pain relief in the lower section of your body because it infuses a numbing medication like bupivacaine or lidocaine. In some cases, you may also receive a narcotic at the same time. You cannot get out of bed after an epidural is placed. If you wind up with an epidural, make sure to engage in frequent position changes to help your baby navigate the passageway during birth.
Birthing options include delivering at a hospital, birth center, or home. It’s vital to realize that your OB provider has specific credentialing and licensing for where they are able to practice. Make sure to converse with them early on to identify where you can opt to birth and if you’re comfortable with it.
So you want to have an unmedicated birth or “go natural”? Your “why” is what you cling to during times that you feel like you can no longer do it. You have faith, values, and reasons why this journey matters to you. Find a mantra and cling to it. Some examples that I’ve heard over the years include:
Typically the when is up to the little person, however this begs the other question: are you open to labor induction or augmentation? Allowing birth to commence on its own is known in the medical arena as expectant management. During expectant management, the baby will pick their own birthday. Other parents prefer an elective induction in which you choose to receive a number of medications to encourage the birth of your baby. Sometimes your doctor or midwife will discuss inducing you for medical reasons, but that’s an entirely different animal!
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June 30, 2020Consider your ideal position in which you would like to birth. Make sure your provider is open to nontraditional birthing positions. I am a huge fan of the hands and knees or left side lying position for giving birth. In some studies, it minimizes tears (source). However, it’s not about me- it’s about you! Make sure your birth attendant knows and supports that. Your baby should be placed immediately in skin to skin (also known as Kangaroo care) following birth unless they are compromised. (source) If you prefer to nurse, breastfeeding within the first hour is critical for success (source).
Don’t waste your precious birth plan space on things like enemas or episiotomies, as those are no longer practiced. Also, don’t say “avoid unless medically necessary” because that gives us a whole lot of leeway. Simply state “if my baby is in fetal distress” or other precise wording.
When in doubt, if you are overwhelmed by what your birth attendants are saying to you, practice with your advocate or partner ahead of time. You should be focused on your birthing! Remind them to ask:
The birth plan is ultimately a conversation starter between you and your healthcare providers. We support you in this beautiful journey to parenthood. However, we also are supportive of changing your mind at any point during labor! Being flexible, should the situation require it, can be empowering.
For a valuable resource, consider the birth plan created by the American College of Nurse Midwives.
This article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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