Today there are many online resources that allow couples to follow a pregnancy week-by-week, providing information on what to expect at each stage of pregnancy. Many of these websites also cover labor, labor management, and delivery choices. After reviewing this material many couples come into their doctor or birth provider requesting a written birth plan.
Birth Plan
Writing a birth plan is much like planning the labor of your dreams. So it’s very important to understand one thing about labor – it is completely unpredictable! That doesn’t mean everything won’t go just fine, but some aspects of your vision of the birth may change as labor develops. In fact, you don’t even have to write up a formal birth plan. You can use some of the online checklists to help you and your partner decide – in a perfect world – what’s important to you during labor and delivery. You might want to give consideration to questions such as: Whom do you want in the room with you during labor and delivery? Do you want to maintain mobility during labor? Do you want to deliver sitting up or lying down? It’s good to think about this ahead of time and share your thoughts with your doctor or midwife.
Management Options
You might also like to consider how you’d like to manage the discomfort of labor and delivery. Some hospitals, such as Phelps, offer acupuncture and massage as options for pain management. I have found these approaches to be quite effective. Hydrotherapy is another option that is available. Tubs and showers are available during labor to minimize discomfort. If you are in a tub you should be immersed so that the warm water covers your abdomen. During active labor the water can relax you, and ease the intensity of the pain. Clinical studies have shown that water immersion can lead to shorter labors. Hydrotherapy is not a water birth, because ultimately the baby will be delivered outside the tub. Some couples have used large inflated exercise balls during labor. This is something you would bring with you to the hospital. Sitting on, or lying down on your back on the ball can provide comfort.
Medical Intervention
You should also give consideration to the medical interventions that are available. There are medications available that are safe for mother and baby and they can be used as a tool for the labor and delivery process. Intravenous sedatives are best used during the latent (early) phase of labor. Epidural anesthesia is used for pain relief and will allow you to stay alert and enjoy and participate in the birth process. Medical advances in the last 20 years have perfected this procedure so less medication can be used for a maximum effect. And then again you might prefer not to use any medication. Labor can be induced, but ideally only for a good reason. If the mother has hypertension, diabetes or the mother or baby are at risk this procedure can be considered. C-section delivery is another option. Ideally this option is used only when necessary. A breech birth (the baby is positioned to exit the pelvis with buttocks or feet first) is an example of a situation where a c-section may be the best option for a safe delivery.
Caregiver
You also have an option to select the caregiver you prefer to work with during your pregnancy and through labor and delivery. At Phelps we have a very active and collaborative certified nurse midwifery practice. Physicians are on staff to support midwives should a labor suddenly need a medical procedure that midwives do not perform, such as a c-section.
Education
It is especially important for couples to take advantage of the prepared childbirth classes offered at many hospitals. At Phelps certified nurses teach a variety of classes including an overview of what to expect in labor and delivery, baby care, breastfeeding and Lamaze childbirth techniques.
Knowing your options can help you and your partner make educated decisions that will ultimately contribute to a very positive labor and delivery process, as well as a beautiful new baby.
Sarina J. DiStefano, M.D. is an obstetrician and gynecologist with Sleepy Hollow Medical Group and practices at Phelps Memorial Hospital Center, 701 North Broadway, Rte. 9 at Rte 117, Sleepy Hollow, New York. 366-3000. phelpshospital.org.
