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From where to have your baby to how to manage the pain,pain, there are many decisions you must make about your baby’s birth. But you must be flexible, as births are unpredictable and don't always go as you plan. Take time during your pregnancy to learn about your options and discuss with your healthcare provider what is best for you and your baby.
A birth plan
A birth plan is a guide for how you would like your labor and delivery to proceed. The word “guide” is key. Since you can never know exactly how the process will go, you need to accept the possibility of changes once labor has started.
What is most important about a birth plan is that it encourages you to consider your options, discuss them with your partner and healthcare provider, and make your preferences known to your healthcare team. Many of the options that you may consider are described in this article.
Where to have your baby
The three main options for where to have your baby are:
Most hospitals offer special accommodations for expectant mothers. These may include a birthing room, which allows a woman to be in the same room before, during, and after her delivery. There are also private rooms with space for family members to sleep. Tour your hospital’s maternity ward to see what services are offered.
Birthing centers are designed to provide a more home-like setting, but with the technology of a hospital within reach. Such centers may be attached to a hospital or be separate entities. A birthing center is appropriate for a healthy woman with a healthy (i.e. low-risk) pregnancy.
Home may be the most comfortable and natural place to give birth. However, because birth can be unpredictable, most physicians do not recommend home births. If you decide to have a home birth, you should have a plan for reaching medical care quickly if the need arises.
Who will assist in your baby’s birth
An obstetrician/gynecologist (OB/GYN) is the most common choice to deliver your baby. If you have a high-risk pregnancy, your doctor may refer you to a perinatologist, which is an obstetrician who specializes in high-risk pregnancies. In some areas, family practitioners receive special training in obstetrics and may also deliver babies. This is more common in rural areas or where there are few OB/GYNs.
A midwife (in many areas, nurse-midwife) is trained and licensed to take care of healthy women who are expected to have an uncomplicated labor and delivery. Midwives have a backup physician who is available for consultation or to step in if complications arise during delivery.
Indications for a cesarean section
Cesarean section (c-section) is the delivery of a baby via surgery, rather than vaginally. The physician makes incisions in the abdominal wall and uterus in order to remove the baby. A c-section is done if the health of the mother or baby would be endangered by a vaginal delivery. Some c-sections are planned, but many occur on an urgent or emergency basis.
Conditions that may call for a c-section include the following:
When considering the possibility of a c-section, remember the number of people allowed in the operating room is usually restricted to one. Consider who you want to be there with you when the baby is born.
If you had a c-section in a previous pregnancy, you may still have the option of a vaginal delivery. Discuss the risks and benefits of having a vaginal birth after a c-section (VBAC) with your doctor, and express your preference.
Putting it all together
Although no one can predict exactly how your delivery will go, you can educate yourself and be prepared for most situations. Read as much as you can and talk with your doctor or midwife and your partner. Also, take the time to outline your preferences before labor starts.
At the same time, remember that this is a natural process, and as much as you can prepare, you also have to be prepared for last-minute changes.
See also
A birth plan
A birth plan is a guide for how you would like your labor and delivery to proceed. The word “guide” is key. Since you can never know exactly how the process will go, you need to accept the possibility of changes once labor has started.
What is most important about a birth plan is that it encourages you to consider your options, discuss them with your partner and healthcare provider, and make your preferences known to your healthcare team. Many of the options that you may consider are described in this article.
Where to have your baby
The three main options for where to have your baby are:
- At a hospital
- In a birthing center
- At home
Most hospitals offer special accommodations for expectant mothers. These may include a birthing room, which allows a woman to be in the same room before, during, and after her delivery. There are also private rooms with space for family members to sleep. Tour your hospital’s maternity ward to see what services are offered.
Birthing centers are designed to provide a more home-like setting, but with the technology of a hospital within reach. Such centers may be attached to a hospital or be separate entities. A birthing center is appropriate for a healthy woman with a healthy (i.e. low-risk) pregnancy.
Home may be the most comfortable and natural place to give birth. However, because birth can be unpredictable, most physicians do not recommend home births. If you decide to have a home birth, you should have a plan for reaching medical care quickly if the need arises.
Who will assist in your baby’s birth
An obstetrician/gynecologist (OB/GYN) is the most common choice to deliver your baby. If you have a high-risk pregnancy, your doctor may refer you to a perinatologist, which is an obstetrician who specializes in high-risk pregnancies. In some areas, family practitioners receive special training in obstetrics and may also deliver babies. This is more common in rural areas or where there are few OB/GYNs.
A midwife (in many areas, nurse-midwife) is trained and licensed to take care of healthy women who are expected to have an uncomplicated labor and delivery. Midwives have a backup physician who is available for consultation or to step in if complications arise during delivery.
Indications for a cesarean section
Cesarean section (c-section) is the delivery of a baby via surgery, rather than vaginally. The physician makes incisions in the abdominal wall and uterus in order to remove the baby. A c-section is done if the health of the mother or baby would be endangered by a vaginal delivery. Some c-sections are planned, but many occur on an urgent or emergency basis.
Conditions that may call for a c-section include the following:
- Cephalopelvic disproportion (CPD) – the baby’s head is too big to fit through the mother’s pelvis.
- Fetal distress – the baby is not receiving enough oxygen.
- Abnormal position of the baby – the baby should be delivered head first with the chin tucked under. If the shoulder, bottom, legs, or extended head is in position to come out first, a c-section may be necessary. When the bottom presents first, it is called breech.
- Prolapsed cord – the umbilical cord is in the birth canal ahead of the baby. The cord may be compressed and cut off the baby’s oxygen supply.
- Abruptio placentae – the placenta separates from the uterine wall before birth. This can cause the mom and baby to hemorrhage, which can cut off the baby’s oxygen supply.
- Placenta previa – the placenta partially or completely covers the cervix. In some cases, this can cause the placenta to deliver before the baby, which cuts off the baby’s oxygen supply.
- Macrosomia – excessive birth weight of the baby makes c-section delivery recommended.
When considering the possibility of a c-section, remember the number of people allowed in the operating room is usually restricted to one. Consider who you want to be there with you when the baby is born.
If you had a c-section in a previous pregnancy, you may still have the option of a vaginal delivery. Discuss the risks and benefits of having a vaginal birth after a c-section (VBAC) with your doctor, and express your preference.
Putting it all together
Although no one can predict exactly how your delivery will go, you can educate yourself and be prepared for most situations. Read as much as you can and talk with your doctor or midwife and your partner. Also, take the time to outline your preferences before labor starts.
At the same time, remember that this is a natural process, and as much as you can prepare, you also have to be prepared for last-minute changes.
See also
