Medical Procedures during Labor & Birth
During your pregnancy, making time to nurture your body and self, and connect with your growing baby will help you emotionally, physically, and spiritually when you go into labor and embark on your journey of giving birth to your baby.
One of the most important things you can do to prepare for this journey is to think about how medical or natural you wish it to be, and then write down your preferences about medical procedures so that during labor, when you will be offered all different kinds of medical procedures, you will have a written statement that explains what your preferences are. This way, the caregivers will know which medical procedures you want and which you want to avoid and should respect your wishes.
You could include your preferences about the following medical procedures:
~ Fetal heart rate monitoring preferences (continuous electronic internal or external monitoring (EFM), intermittent monitoring, or stethoscope monitoring?)
~ Vaginal examination preferences (how frequently do you feel comfortable being examined during labor?)
~ Intravenous fluid (IV) preferences
~ Eating & drinking preferences (do you want to be able to eat and drink normally during labor?)
~ Pain medication preferences (how do you feel about using pain medications? if you want to have a natural birth, explain how important this is to you in your Birth Plan and what natural pain relief techniques you wish to use like massage, hot shower or bath, movement, sound, relaxing visualizations and mantras, etc.)
~ Amniotomy preferences (if your labor is not progressing, how do you feel about your caregiver artificially rupturing your amniotic sac? If you want to have a natural birth, explain that you would want to try natural induction or augmentation techniques like nipple stimulation, movement and changing positions, taking a hot shower, cuddling kissing your partner, acupressure or reflexology, etc.)
~ Stripping membranes preferences (how do you feel about your caregiver separating your bag of water from your cervix in order to induce labor? Or do you want your body to initiate labor on it’s own?)
~ Birthing positions preferences (do you want to be able to birth your baby in whatever position feels instinctual for you? for example standing and squatting, not lying down on bed in stirrups)
~ Pushing preferences (do you want to be able to push when you feel ready, when you feel the spontaneous bearing down sensation?)
~ Episiotomy preferences (if you want a natural birth, do perineal massage during pregnancy, and explain in your Birth Plan that you want to push only when you feel the urge, to push in a position creates largest opening, and you want hot compresses to be used when you are pushing. Also, if it looks like you might tear, would you prefer to incur a natural tear? A natural tear is usually smaller, and heals more easily and quickly)
~ Fetal Stimulation Test preferences if baby shows signs of being in distress
~ Fetal Oxygen Saturation Monitoring preferences if baby shows signs of being in distress
~ Vaccum Extraction and Forceps preferences in case of emergency
~ Cesarean preferences in case of emergency (see my blog post about Gentle Cesarean)
~ Umbilical cord cutting preferences (do you want your caregiver to delay cutting of the cord until blood flow stops?)
~ Skin-to-skin contact and breastfeeding preferences
Sometimes, complications may arise during labor and you may need to make decisions about medical procedures that you had not prepared yourself for. In these circumstances, childbirth educator and doula Penny Simkin has created a list of questions for birthing moms and their partners to ask their care provider in order to make informed choices about medical procedures.
I recommend having this list of questions from The Birth Partner by Penny Simkin on hand during labor so you can refer to it when making decisions about medical procedures if a complication arises:
~ What is the problem? How serious is it?
~ How urgent is the need to begin treatment?
~ What is the treatment? How is it done?
~ How likely is it to solve the problem?
~ If the treatment fails, what are the next steps?
~ Are there any side effects to the treatment?
~ Are there any alternatives?
Additional questions to ask about procedures:
~ What is the reason for this procedure?
~ What are the benefits?
~ What are the risks? What are the side effects?
~ How is the procedure done?
~ Does this procedure always work? If not, why and how often?
~ If it doesn’t work, what will be done next?
~ What other choices are available?
~ What are the potential consequences of not having the procedure done?
I hope this information will enable you to make informed decisions and enjoy an empowering and satisfying birth.