When you think about your baby’s birth, what is the first thing that comes to mind? What moments will be most special? What do you hope will happen and what do you hope won’t happen? Pregnancy is the time to identify things you want and things you don’t want to be part of your labor, birth and postpartum experiences.
Your decisions about what is right for you will be based on your understanding of the many choices available in childbearing. Talk about options with your medical care provider at each prenatal visit so that you become familiar with what to expect. Register for a maternity tour and become familiar with specific policies at the hospital where you will give birth. Read books, attend prenatal classes and begin to consider what matters most to you.
While you are developing ideas about what you want, remember that things can change, and it is very important to stay flexible. Each birth experience is unique, making it unrealistic to plan each detail ahead of time as there are so many variables. Select the areas most important to you and develop contingency plans for those specific areas. Consider your choices, discuss them with your care providers and be willing to adapt to an unexpected situation if necessary.
Here are some sample questions to ask yourself as you prepare for labor, birth and postpartum.
In labor, who do you want to be with you and what do you want them to do? Communicate ahead of time with your partner so that you know what each expects.
Do you want to receive any medication for pain and, if so, what type and when? Will you consider an alternative? Do you want the staff to suggest medication to you or do you prefer to ask for it when needed?
Do you want to watch the baby being born? Do you want someone to take pictures or videos? Of labor and/or birth? Who do you want to see these photos? Making these decisions ahead of time can save a lot of misunderstandings.
Do you want to breastfeed right away within the first hour after birth? Do you want to ask the staff to support your decision to breastfeed by not giving baby a pacifier or a bottle without discussing it with you? (If baby is unable to nurse for some reason, do you want to start pumping your breasts to stimulate milk production?)
Do you want other friends and family to visit you right after the baby is born? Or are you planning to limit visitors in the hospital to allow time for you to get to know your baby, learn to breastfeed and learn all about caring for yourself and your baby? Consider how special the early hours with your newborn will be and think about postponing visitors until after you get home.
Determine what is important to you, discuss everything with your medical care provider, talk with your partners and write it down. Your birth partner can advocate for your requests while you are focused on contractions. You may want to bring notes about your decisions to the hospital to share with your labor nurse as soon as you are admitted. Sometimes the way you communicate your requests can make quite a difference. Consider phrases such as "We would like to do this as long it is not medically contraindicated, "We would like to avoid these things unless it is absolutely necessary for medical reasons." The hospital staff will want to support your choices as long as they are medically safe for you and baby, and they can do this best if you let them know what you are thinking.
Begin to prepare your contingency plans so that you can deal with unexpected changes. Remember to ask questions that will help you be actively involved in decision making. What is the problem and how serious is it? What is the procedure they are recommending, and what will be the next step? What are the potential risks and expected benefits with this intervention? How will it affect mother, baby or labor process? What are the other possible alternatives?
The majority of expectant families agree that a healthy mother and a healthy baby are the main goals for pregnancy and birth. Keep your expectations realistic, communicate with your partner and your medical care provider, and do what you can now to create the birth experience that is special to you.
Editorial provided by Tsulan Balka, RNC, MS, NP, Manager of the Women’s Pavilion at Exempla Saint Joseph Hospital in Denver, Colorado.