Birthing Choices
Posted on July 25, 2007
Filed Under Child Birth |
Here are some questions to think about with your partner and to ask your physician or midwife. They relate to a variety of decisions about birth. Generally, when a woman and her partner have no preference, the physician or midwife will do what she or he is accustomed to doing. Therefore, it is good to know what the usual practices of your provider are and what restrictions are put upon her or him by the institution where your birth will be. If you don’tknow what your own preference would be in answer to any of the following questions, continue reading this book. See the book list in the Appendix. Talk to other mothers and fathers. Look at videos; watch television. Search the internet. And think. Think about what feels best for you. Nobody can really tell you that except yourself.
The Prenatal Core:
- How many members are there in the practice? What are their specialties?
- Will you have a primary provider, or will you see all members of the group during your pregnancy? Will this provider be of your own choosing and can you choose between a physician and midwife?
The Labor:
- Will your primary provider be your birth attendant or will you be cared for in labor by whomever in your group practice is on call that day?
- Can you choose between a physician and midwife to attend your birth?
- Will your physician or midwife meet you in the admitting area of the hospital or birthing center or will you be examined initially by a resident who will then contact your provider?
- Will you have a routine pubic shave (not shown to be effective in reducing infection rates)?
- Will you have a routine enema (not shown to be effective in stimulating or shortening labor and may have side effects)?
- Will you be allowed to walk around in labor (shown to help reduce the length of labor)?
- Who and how many people will be able to accompany you in labor?
- Will children (if you wish) be able to be present in labor?
- What is the provider’s rate of epidural anesthesia? The institution’s? What other pain relief measures does the provider generally utilize or recommend? If you have an epidural, will it be a low-dose, “walking” epidural?
- Can you bring your own pillows, clothes, food?
- Will you be able to eat/drink in labor?
- Will you routinely have intravenous (IV) tube feedings?
- Will you have routine continuous electronic fetal monitoring, intermittent electronic fetal monitoring, or intermittent monitoring of the fetal heart tones by fetoscope? Will the type of monitoring be determined by your risk status?
- What is the limit to how long each stage of labor will be able to go on, as long as progress is being made?
- What is the limit to how long you will be able to push as long as progress is being made?
- Will you be able to push in a variety of positions, such as kneechest, side-lying, squatting, on the toilet?
The birth
- Will you be able to birth in the same-room as your labor?
- Will you be able to birth in a variety of positions, including squatting or side-lying, as you prefer at the time?
- Who and how many people will be able to be with you at the birth?
- Will children (if you wish) be able to be present for the birth? • Will your partner or other support person be able to cut the umbilical cord? Will he or she be able to put hands on the baby at the delivery?
- Is there a policy regarding audio or video taping of labor and/or birth should you want this option?
- What is the physician’s or midwife’s rate of episiotomy (should be very low as routine episiotomies have not been shown to be beneficial) ?
- What is the provider’s rate of cesarean birth? (This may be difficult to evaluate as it will depend on the type of practice the provider has; for example, if the provider is known as a “highrisk” physician, or is certified in the subspecialty of maternal and fetal medicine, other physicians may send women with serious problems to this physician, increasing her or his cesarean birth rate. in any case, it should be as low as possible. The Healthy People 2000 goals of the U.S. Public Health Department advised a cesarean birth rate of 15 percent by the year 2000. While this takes into consideration not only what is desirable, but what is possible, It can be used as a reasonable cut-off for a cesarean birth rate, even by a specialist in problem pregnancies.)
- Will your partner/support person(s) be able to accompany you if you have a forceps, vacuum, or cesarean birth?
- Will you be able to have epidural anesthesia for a cesarean birth, except in the situation of severe fetal distress requiring the fastest type of anesthesia available (most likely general anesthesia)?
The period after birth (postpartum)
- Will you be able to hold the baby immediately? Will the physician or midwife put the baby on your abdomen as soon as s/he is born?
- Will you be able to nurse immediately after birth?
- Will you ever need to be separated from the baby-i.e., will you have 24-hour rooming-in starting immediately?
- Will the baby’s physical examination be at your bedside or, if not, can you go to the newborn nursery for the examination?
- How many hours/days will you and the baby need to stay in the hospital/birthing center?
- Will you be able to stay in the hospital if the baby needs to remain there longer than you do?
- What kind of emergency care is available should the baby need special care? Is this care on-site or via transfer? If transfer, what is the transfer system?
- Will the nurses give the baby formula if you do not have 24-hour rooming-in or will they wake you up to nurse?
- Does the hospital have a breast-feeding specialist or lactation consultant on staff?
- What, if any, type of classes for newborn and mother care are available postpartum?
- What are visiting policies postpartum-for your partner, other family members, friends, other children? Does having visitors mean the baby will have to go to he nursery?
- If your baby needs special care, is kangaroo care available ? What are visiting policies for the mother/father/others in the special care nursery (often called the NICU-Neonatal intensive Care Unit)? Can the parents participate in the newborn’s care in this nursery?
Tags:baby, birth, birth attendant, birthing choices, Child Birth, childbirth, labor, postpartum prenatal core
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