Childbirth Options Chapter 5.3

Prepared Childbirth Reducing pain and fear during the birth process through education and the use of breathing and conditioning exercises. Childbirth classes Hospitals Health care providers Private teachers Childbirth classes help parents feel more prepared and ready. Childbirth classes help father feel more involved, especially if they could not be at doctor visits.

Delivery Options Health Care Professionals Places to Give Birth Obstetricians Family Doctors Licensed Midwives Places to Give Birth Home Hospital Alternative Birth Center

Obstetricians Specializes in the care of mothers and babies both before and right after birth. Qualified to handle any emergencies that might occur.

Family Doctors Some family doctors provide prenatal care and deliver babies. If problems arise, they may call an obstetrician.

Licensed Midwives A health care professional trained to assist women in childbirth. Certified Nurse Midwives – Registered nurses Certified Midwives – Still certified, but not a nurse Must pass certificate exam before they can practice Advanced training in normal pregnancy and birth Will call an obstetrician if a complication arises.

Doula Woman experienced in childbirth who provides advice and support to a mother during labor and after childbirth Suggestions – how to cope with labor pains Keep mother calm and focused during delivery Hospitals usually allow father and doula in delivery room

Home Home is familiar and comfortable If problem arises, may not have help on hand that is needed Usually delivered by midwife for home delivery Doula may be present along with midwife

Hospital 2-3 days, up to a week in hospital Have full staff of trained professionals if something were to go wrong Staff will teach mother how to care for baby after birth Sanitary conditions High-tech medical equipment Usually doesn’t allow much food or drink, only ice chips

Hospitals Offer Classes that prepare for delivery and infant care Programs for siblings and fathers Private rooms, soft lighting, music, comfortable furniture One room for labor, delivery, and recovery Additional medical equipment out of sight, but ready for use if necessary Mother and baby to room together, optional

Alternative Birth Center A facility that provides a more homelike environment for labor and delivery Food and drink offered Emphasized on prepared, natural childbirth Do not offer pain medication May offer large beds for both mother and father Music and friends usually allowed

Alternative Birth Center Continued Birthing tubs for water birth Midwives usually handle births at a birthing center Hospitals and obstetricians are on call Cost is less Time spent at center is shorter Leave within 24 hours if no complications

The Birth Plan A document that outlines their preferences for the management of labor, delivery, and postpartum care. Prevents mother from having to communicate wishes while in labor if caregivers change at last minute. Caregiver Choices Obstetrician Family Practitioner Certified Nurse Midwife (CNM)

The Birth Plan – Step 1 Where? Hospital Birthing Center Home

The Birth Plan – Step 2 Who Will Be There? Spouse/father Mom Sister Other kids In-laws Best friend Doula Two or more people – consider birthing center or home

The Birth Plan – Step 3 Child Birth Choices Lamaze Bradley Special breathing techniques Mental focus on eternal object Open to pain medication during labor Bradley Normal breathing Inward focus on self Pain meds discouraged 12 – 2 hour classes Hospital or Birthing Center Methods taken from a range of birthing approaches

The Birth Plan – Step 4 Pain Relief Natural Medicine Massage Acupressure Water: Jacuzzi, Shower, Bath Medicine Epidural – blocks nerve paths “Walking” epidural - permits mobility I.V. Pain killers - Demerol

The Birth Plan – Step 5 The Big Moment Who cuts the cord? Dad? Mom? Caregiver? Cut right away? (Allows for cord blood banking) Wait 5 minutes, when the cord stops pulsing? (Some people believe that getting all of the placental blood will supply baby with more oxygen while it is learning to breathe on it’s own) Baby’s first stop? Baby can be placed on your chest immediately, giving bonding time A chance for your baby to nurse before routine tests begin

The Umbilical Cord Blood Cord Blood Banking What: Newborn’s blood from umbilical cord and placenta is collected at delivery and frozen. Why: Abundance of stem cells, which could help baby (or even another family member) in case of future illness. Cost: $300 - $1,000 for collection; $100 - $150 for yearly storage fee Can donate to a public collection bank.

Birth Plan Issues Your own clothes vs. hospital gowns Music and dimmed lights Clear fluids vs. ice chops for hydration Continuous vs. intermittent monitoring of baby Medical vs. non-medical pain relief

Birth Plan Issues Continued Position for pushing Episiotomy vs. natural tearing Emergency contingencies Shared vs. private hospital room – Insurance may not cover private room

C-Section Pain Relief C-Sections account for 23% of US Births Epidurals are used – mom stays awake General anesthesia, which is fast acting, is used in emergency C-Sections (Mom is asleep) Medications for incision will not enter the birth breast fluid baby drinks (Colostrum) But once regular breast milk comes in fully a couple days later, you should not take any pain meds without consulting your doctor.

Assignments Birthing Plan Assignment

Summary Questions How can a mother be prepared for childbirth? What are the options for who can deliver your baby? Where can you deliver your baby? What is a doula and what do they do?