What are my options for pregnancy care and childbirth?
Depending on where you live, there are many birth options available to women here in the United States. While the majority of women choose to go the modern traditional route of a local OBGYN and hospital birth, there is an upswing towards the age old tradition of seeking care with midwives who deliver at your home or in a free-standing birthing center. Even less popular but still utilized is the option for an unassisted home birth. If you are not sure of your state laws regarding home birth and midwives, you can check them here.
What’s a VBAC?
VBAC stands for vaginal birth after cesarean. You will also run across terms like VBA2C or VBA3C, specifying how many previous cesareans a mother had before trying for a TOLAC (trial of labor). ACOG states in their findings that “Most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered TOLAC.” You can read the entire publication here.
Is a water birth safe?
Water birth, while considered a safe method of birth, should always take place under the supervision of a health care professional. Midwives, birthing centers and obstetricians are growing more fond of this type of delivery since most of them believe that by reducing the stress during labor and delivery, it also reduces complications with the baby. Babies who are born under water are typically very calm and do not cry until jostled or startled.
Where should I deliver my baby?
If you are considered to have a low risk pregnancy, your options on where to deliver is a simple one: Wherever you are most comfortable! If you are not considered low risk, then you will need to make a decision with your care providers regarding what facilities have the ability to meet your needs. Do the research ahead of time regarding your local facilities, so that you can make an informed decision with your care provider. Knowing the differences in policies between facilities and healthcare providers will help you decide what’s best for you.
Who can deliver my baby?
Any licensed midwife, certified nurse midwife, or any person with a Medical Degree in Obstetrics is able to deliver your baby. When choosing who will deliver your baby, first decide what you want your birth to look like. Then you will be able to meet with providers to interview them and see if they will support your wishes, and have the statistics to back it up. Remember: You are hiring them to provide a service! I always tell my clients “If you hired someone to clean your house and they told you they were going to do it their way after you explained your wishes, what would you do?”
You MUST be able to trust your provider, especially if it means they might have to give you an answer you don’t want to hear.
I’m carrying twins; will my delivery be more painful?
If you are carrying multiple babies, the most common method of delivery is cesarean section. Cesarean section for twins is longer, but recovery is generally the same and you will be given pain medication. While most hospitals and providers here in the US are against vaginal birth of multiples (in some states there are laws against it), there are some hospitals and doctors willing to let mothers deliver vaginally if the babies are positioned properly. While vaginal birth of twins isn’t more painful, the pushing stage happens twice making it sometimes feel as though it is more painful.
When is it okay to induce labor?
There are many reasons your midwife or doctor may want to induce you. Some of those reasons might be: Macromesia (a baby over 11lbs.), going 2 weeks past your due date, or other health risks such as those related to blood pressure or diabetes. Inductions should not be taken lightly, as they raise your risk for unwanted birth outcomes. A provider should always include you in these decisions and provide written materials upon request regarding their suggested plan of action. Informed Consent is the law!
What are the different ways of inducing labor?
The most commonly used methods used in hospitals are Pitocin, prostoglandin, and stripping of membranes. Some providers may prefer to use amniotomy (breaking your bag of waters), though this isn’t generally recommended until an established labor pattern and cervical change has begun. Alternative methods of induction are nipple stimulation, sex, and acupuncture. Remember: Talk to your provider about all options!
How early in my pregnancy should I pack a bag for the hospital?
No matter where you choose to deliver your sweet bundle of joy, you should always pack a bag for the hospital. You are considered safe to deliver at 37 weeks, so most moms like to have their bag packed and ready to go at that time. But remember, most first time moms carry into their 41st week!
Do I need a birth plan?
Most providers and hospitals will ask you if you have prepared a birth plan or have any special wishes or restrictions. We strongly suggest writing or at least researching your birth options just for the educational purpose of it. You might be amazed to learn all your options! (did you know you can catch your own baby?!)
What positions can I deliver my baby in?
The standard position for delivery is on your back, with your legs in the air, but did you know you have other options? If you haven’t received an epidural, most hospitals have squat bar attachments for their beds, birthing chairs, and are willing to let you move around with support if the conditions are safe. As doulas, we witness women deliver on hands and knees, hanging off their husbands in an inverted squat (think octopus on the swing set in elementary), squatting on the bed or floor, standing, and sitting cross legged. Find what works for you and your pelvis and don’t be afraid to use it!
