I welcome additional feedback, links, options, and articles that you found/find helpful and interesting.
It’s time to think about your birth options and what you want out of your experience. A great way to know this is to take a quiet moment, perhaps in the tub, with candles lit and a glass of sparkling grape juice. Let your mind wander and then ask yourself – how do I envision my birth? Dream up as many details as possible.. now start to consider how you can make this happen in the place of birth you have chosen. This is a great way to start working on writing a birth plan.
A birth plan is a GREAT way to facilitate good communication with your birth team before labor even begins. So, your homework this week is to start writing out your birth plan. I broke the email down into sections, much like what you might see in a typical birth plan. The Pre-labor section is for your education and your/my conversation, I recommend only putting in a birth plan what happens once you get to your care provider - as that is when they typically have access to it. Try to keep your birth plan short and sweet, with a positive voice, less than a page long, and not a list of "DON'T"s. Be open minded as birth is as organic as you are... and let's get researching!
- Due Dates - the average for first time moms is 41 weeks and 1 day. Maternal family history, how many prior children she has, and other health matters come into play as well.
- Cervical Checks in Pregnancy - oftentimes done from week 36 and on to establish 'baseline' before labor begins
- Inductions - starting labor from nothing.... but also good information for if/when augmentation is recommended.
- Cervical Checks in Labor - oftentimes recommended every 2-3 hours during labor.
- Water Breaking/PSROM and AROM - only about 10-20% of women start labor with their waters breaking, and sometimes it takes awhile for contractions to start. It is common practice for a care provider to assume consent of AROM or breaking your water for you during labor unless otherwise specified. If you have feelings either way, be sure to share them with your provider.
- Doesn't It Have To Break?
- In Defense of the Sac
- Keeping My Sac Intact
- Medical Recommendations for AROM
- Active Birth Practices - labors are more comfortable and manageable, and labor progresses better, when women remain upright and don't recline in bed.
- IVs or Self-Hydration and Nourishment - most hospitals don't want you to eat during labor, but that doesn't mean you can't.
- Music During Labor - an option for Relaxation
- Fetal Monitoring - monitoring baby during labor
- Medications - medicated options for pain management
- Positions for Birth - more than just on your back
- Pushing - more than just counting to 10
- Episiotomy vs Tearing - differences between them and how to minimize risk
- Cord Clamping - the cord is generally clamped and cut within seconds of birth unless you note otherwise prenatally to your provider and remind them during birth.
- Penny Simkin and Cord Clamping
- What About Afterward
- 15 Minutes Could Change Your Life
- Essential Resuscitation Equipment
- Cord Clamping and Preemies
- Skin-to-skin vs. heating lamps - baby can be brought immediately to your chest with a blanket over the two of you, or baby can be brought to the heating lamps to be cleaned and wrapped up.
- The Importance of Skin-To-Skin
- Skin-To-Skin Contact
- Effects on Newborn and Mother
- Guess What Makes 'Em Happier and Warmer
- Early Skin-To-Skin
- Breastfeeding - benefits, when, why, and how.
- Colostrum and Baby's Stomach Size
- What About Afterward
- Common Pitfalls of Newborn Breastfeeding
- Timeline of a Breastfed Baby
- The First 24 Hours
- The ABCs of Breastfeeding
- Nursery vs. Rooming In - in the nursery, your baby will be in a warming bed, rarely held, oftentimes a pacifier and/or formula will be offered to baby as a compassionate gesture to allow mom to sleep longer. Also, when baby is brought to mom for nursing, oftentimes baby is already upset and crying. On the other hand, rooming in may mean shorter sleep periods for mom, but will ensure you hear babies early cues for breastfeeding, ensure baby learns to self-regulate body temperature faster, and give you a better start for bonding and sleep synching.
- Bathing of the Newborn - normally done before discharge, more often than naught, in 'transitional nursery' or within 2-4 hours after baby is born - either in room or in the nursery.
- Vitamin K - given postpartum to baby as an injection unless otherwise requested through oral administration or declined. Normally administered within 2-4 hours after birth.
- Eye Erythromycin - administered into the eyes of the newborn normally within the first 2 hours after birth.
- PKU - a blood test done to baby through a heel stick normally within the first 2 days of life. One discrepancy is that the PKU results have a high false-positive result until after the baby has received 24 hours of breastmilk (not colostrum). Breastmilk doesn't normally come in until days 3-5.
- Hep B/Vaccinations - an injection given to baby usually within the first 2 days of life to protect against Hep B transmission/infection.
- Circumcision – removal of the prepuce (foreskin) of a boy’s penis. Done in hospital before discharge unless requested of a mohel, in which case it is done on the 8th day after birth.
- Placenta/Postpartum Pitocin – normally a placenta is either discarded by the hospital staff or sent to pathology for testing and medical practice. You can ask to take it home with you, or just ask to be shown it after birth.
All options for family or mother-centered cesarean can be found in the following links.
- Best Cesarean Care Plan – most information is for a planned cesarean
- Keep your plan to one page.
- If you can't, consider having two to three plans: a birth plan, a cesarean plan, and a newborn plan. Separate sheets for each - this also allows you to put the baby plan in the warmer so that the nursery staff can read it while you're birthing your baby and have less questions postpartum.
- Keep out the unnecessary (i.e., they no longer shave you and give you an enema for a vaginal birth, so don’t include that information).
- Keep it on purpose – if you are writing a birth plan, you don’t need to include information about your pregnancy care.
And for some comic relief...