In the U.S., we have fallen into a “one size fits all” approach to caring for women in labor. Upon arrival at the hospital when she’s in labor, a mom is given a dull open back hospital gown to change into, she’s hooked up to a monitor, blood pressure cuff and given an IV. She may then be instructed to stay in bed to make continuous monitoring of her baby’s heart rate more convenient for the staff caring for her. These protocols (and many others) will be carried out routinely, in the absence of your birth plan. Routine procedures and interventions carried out on an otherwise healthy mother and baby, can have many negative affects on the progress of your labor and may possibly cause the very problems and emergencies we are hoping to avoid through the use of medical interventions.
It is rare that the birthing mother is seen as an individual who is undergoing an incredible life transition as she brings forth life from her body. Medical providers are very caught up in the physical act of getting baby out and often take little time to assess mother’s emotional needs and her own specific physical needs. In creating a birth plan, we are asking everyone to take a step back from the regular protocols, and treat us according to our specific medical and emotional needs. As we know, mom’s emotional state is directly related to her physical comfort and progress in labor.
So how can parents ensure a natural flow of labor?
Discuss your birth preference early and often with your care provider.
Approach your care provider with sincerity and assure them that if there is a true medical emergency that warrants intervention, they’ll have your support. If you don’t get the feeling that your doctor or midwife is going to support your wishes (in the absence of medical problems) or that your provider does not share your same philosophy about birth, consider switching to a provider who will.
Ask your doctor or midwife to sign your birth plan, and bring it with you to the hospital on your birthing day.
Items to Include in your Birth Plan:
- To allow labor to start on its own (read more about induction of labor)
- No IV unless medically necessary (birth partner will help mom maintain fluid intake and output) Read more about routine IV use in labor
- Intermittent Fetal Monitoring (rather than continuous). Generally docs will support 20 minutes on and 40 minutes off of the electronic fetal monitor.
- Freedom of movement
- Few or no vaginal exams, always with explanation of need and mother’s consent
- To eat and drink as desired
- To forego medical interventions, including breaking water and augmentation (with pitocin etc) without clear medical need. Membranes to remain intact until baby is fully born.
- To exercise patience if labor slows or rests
- Mother directed bearing down instead of coached pushing
- No episiotomy unless there is an emergency and only after consultation
- Allow time for placenta to be birthed naturally without the use of pitocin (in the absence of emergency)
- Delay clamping and cutting of the umbilical cord, until pulsations have cease
For Baby :