Saturday, July 11, 2009

Tips to take to the delivery room

When babies are born, they come out of where? As a child, we are astonished at how a baby can come out...but as a grown-up we are supposed to do it! Below I have listed 6 pieces of advice (my research-based opinions) for the big day.
  1. Birth Plans are helpful - mostly to you, your spouse/partner and your doctor. When writing my birth plan, I had to do my research. The plan gave me the perfect opportunity to discuss my "ideals" with my husband (important since he's there to advocate me when I can't.) It also gave me a clear list of things I needed to go over with my doctor. Some hospital nurses may read birth plans (as they should) but I know my first nurse did not. If I'm ever a Labor and Delivery nurse, I will read birth plans.
  2. Allow labor to begin on its own, inductions and augmentation of labor should only be done if medically necessary (3).
  3. Beware of Pitocin. Pitocin can be great or it can be EVIL. Sometimes it is medically necessary but if it isn't necessary, just don't do it. I didn't go with pitocin, even after one nurse said I would need it due to risk for infection. Luckily I am informed and knew that I wasn't at risk for infection only 8 hours after my water broke. Also, I knew that if I did start to run a fever (a sign of infection) it would be okay because in our country we have running water AND antibiotics! I argued with that nurse through my contractions and was able to go epidural free for another 3 hours. Luckily, the next nurse I had wasn't the threatening type.
  4. Try to have the baby while in the side-lying position - first-time moms are less likely to have bad tears in this position. If you choose side-lying, lay on your left side because more oxygen can get to your baby this way. Lying on your right side is fine also, just not as ideal (FYI, I was on my right because the left side was too uncomfortable for me.) Squatting is probably the best position (1) but it's not going to happen if you have an epidural. If you aren't a first time mom, then your position is less important.
  5. Try not to be too eager for the epidural. I chose to go as long as possible without an epidural. I am all for natural births but once you hit about 5 or 6 centimeters, it gets tough. I just wanted to be able to walk around the room, the hall, get in the shower, GO TO THE BATHROOM, and simply be mobile as long as possible. Based on all that I read, I felt it was healthier for my baby and me to go without the epidural for longer.
  6. Labor down - Don't push until head is visible in perineum if baby is healthy and showing no signs of distress. (Perineum is your vaginal opening.) Instead, sit upright in bed and wait for baby's head to come down with gravity. This saves you a lot of effort and shortens the pushing time. Recent studies have also shown that prolonged pushing time may not be healthy for mom or baby (2).
  7. Read Ina May's Guide Childbirth and have no fear. I just thought, "my body was made for this." Lamaze also helped.
  8. Avoid all unnecessary medical intervention (3). Having a baby is a natural and healthy process. Healthy babies are born every day without the help of a doctor or hospital. I do believe the hospital is the safest place to have a baby, just in case something does happen. But, just because you are in the hospital, it doesn't mean you have to have a "medical" birth.

1. Does Epidural Analgesia Affect the Rate of Spontaneous Obstetric Lacerations in Normal Births? Journal of Midwifery and Women's Health. 2007.
2. Management of the Second Stage of Labor in Women with Epidural Analgesia. Journal of Midwifery and Women's Health. 2008.
3. Preserving Normal Birth. Journal of Obstetrics, Gynecological and Neonatal Nursing. 2008.

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