If you’re expecting a baby, you’ve likely been planning ahead — stocking up on diapers, newborn clothes and blankets, as well as considering how you’ll name your new little one. The thing about childbirth is, you can never be certain what’s going to happen, for it can get out of control at any time and that’s where a well-established birth plan comes in helpful. As women become more aware of their rights to choices, even the atmosphere and procedures during labour can be pre-discussed in some hospitals. The way to do this is through a birth plan.
What’s a birth plan anyway?
A birth plan will help ensure that certain aspects of your childbirth experiences, such as pain medications you wish to use or avoid, people allowed in the delivery room, episiotomies and cord-cutting are all planned out the way you want it.
How it works is, firstly, you establish your wishes in writing. Next, talk them over with your doctor as well as hospital staff including your midwife, and then see to it that you, your doctor and the hospital staff each have a copy. It’s actually really important to discuss your birth plan with your doctor and hospital staff to ensure that everyone is on the same page with you on all your wishes. Keep in mind too that some of your wishes may not be in line with the hospital policies too, so early discussions will help you sort out these issues.
Times have changed and so can birthing experiences
Many hospitals have geared up to accommodate patients’ demands for comfort during labour. More and more hospitals are now allowing women to walk around during labour, and even birth in positions more comfortable for them – while squatting, sitting up, etc. It is not uncommon now to be able to make requests which you think will be more favourable to your birthing experience. However, these options vary among the hospitals.
Procedures during labour: Voice out your preferences
It used to be that hospitals practised the same procedures on all women in labour, but many now show increased flexibility in how they handle their patients. Some examples include:
- Enemas. Popularly used to clean out the bowels, enemas used to be routinely administered when women were admitted. Now, you may choose to have one or skip this procedure.
- Shaving the pubic area. Once routine, shaving is no longer done unless a woman requests it, so if it’s not your cup of tea, state it in your birth plan.
- Inducing labour. At times, labour may need to be induced or sped up for medical reasons. However, some practitioners these days are willing to give women the option of getting some help to move things along naturally, or giving labour a little more time to progress on its own. State your wishes regarding this in your birth plan after discussing it with your doctor.
Pain management
Although many women feel that they will be able to give birth sans pain medication, this is one area that women are advised to keep an open mind and not to be too rigid with their plans to the point of not being able to enjoy their birthing experience. In any case, many women who think they will be able to withstand the pains of labor only end up changing their minds asking for an epidural when they’re too far along in their labour.
Pain management is something worth discussing carefully with your doctor while taking into account all the possibilities during labour. Even if you opt for a natural birth and intend to forgo the pain meds entirely, know that you can change your mind during labour, no matter what you have stated in your birth plan. Doctors and staff are not going to judge you! Be well-informed too of alternative forms of pain relief, including massage, relaxation, breathing, and hot tubs. Know your options and make your wishes known to your doctor.
Birthing position
Slowly but surely, the days of giving birth in just one position, that is lying down with legs apart or on stirrups, are becoming passé. Many hospitals nowadays are open to allowing women to try a variety of more comfortable or favorable positions during labour, including lying on the side, squatting or sitting up. It’s just a matter of early discussion and planning with your doctor and hospital staff.
Episiotomies
Doctors perform episiotomies when necessary. (An episiotomy is when the perineum — the area of skin between the vagina and the anus — is partially cut to ease the delivery). You may need to have one in medical emergencies, such as if your baby is in distress, or if there are risks of really bad tearing. If you are strongly against it, do discuss your preference with your doctor.
Who will be allowed in the delivery room?
Not only is this an important thing to include in your birth plan, but also, how will they be allowed to witness the birth? Will they be standing at the head of the bed, the side, or the foot of the bed?
If it’s your wish that the whole family is welcome as long as they stay near the head of the bed, state it clearly in your birth plan. Or, if you’re totally fine with a relative witnessing the birth of your child at close range, state it too! Just establish all these early and don’t assume that your partner or hospital staff knows what you want.
Writing a birth plan for a cesarean birth
At any given hospital, the surgeons, doctors, nurses and other medical staff who work there witness all sorts of emergency cases from day to day and hence, it would be safe to say that they would be less likely to see the ‘urgency’ of something that might be important to a patient. For them, saving lives is all that matters. Hence, if you were to need an emergency cesarean for some reason, it will likely be ‘just like any other cesarean section’ to them. Procedures will apply and these do not include the preferences of the mom-to-be. From their perspective, procedures will simplify their work since everyone knows what to do and when.
You can reclaim your right to empowerment throughout your baby’s birth without giving many problems to the hospital by creating a cesarean birth plan, just in case you do end up having one. It’s just so you’ll be well-prepared, regardless of any unforeseen circumstances that may pop up in your birth journey. Remember though, to sit down with your doctor and whichever hospital staff involved and discuss each one in detail, as an affirmation that it’s how you wish things to be if you were to undergo a cesarean. The earlier you do this, the better, for they too will have ample time to discuss the needed steps to be taken to take care of your requests.
The following are some preferences that you might want to include, or you may have your own.
Mode of oxygen
If you feel it’s disorienting to have your nose and mouth covered during this monumental experience, request to have your oxygen delivered via a nose plug instead of a face mask, so it’ll be easier to gurgle and coo at your precious newborn as soon as he or she emerges.
The restraining of your arms
It’s quite a norm in some hospitals to restrain the mother’s arms during a cesarean section. While some moms do not mind this procedure, it does still prevent an eager mom from immediately holding her baby after birth. The freedom of your upper body creates a greater sense of control and easier postpartum bonding, even if your lower body is numb during the surgery. Some moms find comfort during a cesarean birth by hugging themselves or holding their birth companion or husband/partner.
Personal conversations during your cesarean
This isn’t as over-the-top as it sounds as far as preferences go, for nothing kills the beautiful and sacred nature of your birth experience like having to listen to what the surgeon took his family for vacation or what the nurse thinks about her in-laws. Politely indicate that it would be highly appreciated and that you’d be grateful if in the event of an emergency cesarean, the surgical team were to keep all conversation related only to your baby and you.
Holding your baby directly after birth
If both your baby and you do not run into any complications, the staff should not have a problem with this. So, a state in your cesarean plan that you’d appreciate the opportunity to caress your baby for a while as soon as he or she is born, or while your surgeon closes your incisions. After that special bonding time with you, your baby can be taken to be cared for.
Your choice of music played during the cesarean
Music is a powerful tool that can alter one’s mood. The thing is, some surgeons also are fond of music while they’re performing surgery. Hence, imagine if you will, a particular tune that does nothing for you, or worse, that you despise, being played in the background during your cesarean section, for it happens to be the surgeon’s favourite!
In this case, your preference should win, hands down! Decide what (if any) music or recording you would like playing during your child’s birth and find out the best way to play it (e.g., recording on your phone, CD, etc.).
Post-birth
Post-birth decisions to be made beforehand should include:
- Whether your partner is going to cut the umbilical cord.
- Does your partner want to hold the baby when the baby emerges or
- Do you want immediate contact with the baby, or
- Would you like the baby to be cleaned off first?
- How would you like to handle the delivery of the placenta? Would you like to keep the placenta?
- Do you want to feed the baby right away?
