I'm Pregnant, Now What?? Choices in Childbirth

It finally happen. The double pink line or the "+" appeared on the test. You are pregnant!! Congratulations!

Now what?!?!

After you've celebrated and shared the news, the next call you make is to your doctor to schedule your first appointment. It makes sense right? This is the doctor you've been seeing for your well woman visits and you do plan on giving birth at the closest hospital, right? That's what you should do, right? It's what everyone does, right?

Not that your doctor who you've been seeing for the last few years won't deliver your baby and not that you won't go to the hospital that is 5 minutes from your home, but you have other options. This is your birth and you DO have choices.

Did you know that you do not have to deliver laying on your back like you see in the movie?

Did you know that you can and it is often helpful to move throughout labor?

Did you know that there are trained healthcare professionals that specialize in normal childbirth?

Did you know that you do not have to have constant electronic fetal monitoring?

Did you know that the hospital is not the only option you have to give birth?

Take as much time deciding which stroller your baby will ride in as who will be apart of your healthcare team when he or she is born.

The Coalition for Improving Maternity Services has put together 10 questions to ask your healthcare providers that might help you as you explore your birth options. The questions include everything from who can be with you while you give birth to what you can expect while you are in labor.

Learn your options. Educate yourself. Become empowered so that you can make the best decisions for you and your family.

Mother & Baby Friendly Cesarean

The United States cesarean section rate is rising at an alarming pace. While we need to educate ourselves about and discourage the use of unnecessary cesareans, the medical necessity of the procedure has allowed for healthy outcomes for countless mothers and babies. (me to be included!)

For those mothers and babies that medically require delivery by cesarean I argue that we should explore the option of a mother/baby friendly experience. The Natural Cesarean: A Woman-Centred Technique (pdf file) is an article published in the BJOG: An International Journal of Obstetrics and Gynaecology exploring the option of the parents being active participants in the birth of their baby.

What would a mother/baby friendly cesarean look like? According to the authors of the article:

• The drape would be lowered and the mother's headed elevated so that she may witness the birth.
• The partner would be allowed to observe as well
• Baby would be allowed to slowly emerge helping to expel liquid from its lungs as it would during a vaginal birth
• Rest of delivery is allowed to occur passively as the uterus continues to contract
• Clamping of the cord is done in front of both parents and the partner is permitted to cut if desired
• Baby is brought between the mother's breasts for immediate skin to skin contact and offered a chance to suckle
• Baby is allowed to remain on mother's chest until the surgery is complete. Procedures (labeling, Vitamin K, etc.) that can be completed in this position are.
• Once surgery is complete, partner accompanies baby for weighing and remaining procedures
• Upon completion of procedures, baby is immediately returned to mother for skin-to-skin contact

A cesarean section is major abdominal surgery. This birth experience is not suitable for all cesarean births, but I think, as suggested by the authors of the article, this option can be explored for non emergent situations. The International Cesarean Awareness Network has also written details about how to have a family centered cesarean.

If your medical situation dictates that a cesarean is the safest way to deliver your baby discuss your options with your doctor.

Savoring Those First Few Moments - Umbilical Cord Care

For hundreds of years, midwives have practiced delaying the clamping of the umbilical cord after birth. The delay has proven harmless to baby and mother and offered the benefit of allowing for additional bonding time for the family.

A recent study published in the American Medical Association Journal by a group of pediatricians suggests that premature clamping of the cord is actually harmful and delaying clamping may help prevent respiratory distress syndrome.

As reported in Time:

Delay allows a gradual change from fetal to regular circulation without putting stress on blood vessels in the lungs and elsewhere in the body. The carefree manner in which the newly born infant is "disconnected" from his mother, concludes the report, "is in sharp contrast to the meticulous care with which the thoracic surgeon separates his patient from the heart-lung machine."

Ask your health care provider about their policies on cord clamping and discus with them the option of delaying the procedure. There is no rush.