Tuesday, April 14, 2015

Preparing for Natural Childbirth, Part 2: Our Birth Preferences

If you haven't already, check out Preparing for Natural Childbirth, Part 1 to learn about all our research and the preparations that went into writing these birth preferences.

Also, please keep in mind these three disclaimers while reading.

First, I have no idea how our labor and delivery will actually go, obviously. 

Also, I've never done this before, so consider me a novice.

And finally, these are our preferences for birth. They are in no way a judgement of your preferences for birth, how you've given birth in the past, or how you plan to give birth in the future. Please do what's best for you and your family!

Now it's time to dive into our birth preferences. Notice, we're not calling this a birth plan. Amy, our doula, suggested using the term "birth preferences" since that's really what they are. We'd prefer for birth to go exactly this way, but we know babies make their own plans, and so, since we don't actually have any idea how our labor and delivery will go, it's best to call these preferences. We'll still do everything in our power to make them happen, but won't be too disappointed if they don't work out.

Our birth preferences really kick in once we get to the hospital, but before we head there, we plan on laboring at home as long as possible. At home, you're really in the most relaxed environment possible for you and relaxation equals faster dilation. You can eat and drink whatever you want, and there are no interruptions, no monitors, no restrictions, and so on. It's most peaceful, and a peaceful place is a great place to be when you're laboring. Amy plans to be with us in our apartment as soon as we call on her, to help us through the hours of early labor, and then she'll ride with us to the hospital as soon as contractions are getting close and strong. We hope to be past 6 cm dilated by the time we arrive at the hospital. And from there, that's where things'll really take off...

Our Birth Preferences

During labor, Stephanie would like...
  • To walk and move around freely.
  • Dimmed lights.
  • The door closed for privacy.
  • Quiet voices.
  • As few interruptions as possible.
  • Intermittent monitoring.
  • A heparin lock if IV is deemed necessary, so that she can move freely.
  • Her water to break naturally.
  • No internal fetal monitoring.
  • Vaginal exams only upon consent, and as few as possible.
  • For John (husband) and Amy (doula) to be with her at all times.
  • To use natural pain relief techniques, such as breathing, massage, showering, sitting in the tub, etc. Please do not offer any pain medication.
  • To push only when she feels she should.
  • To choose the position she delivers in.
  • To have warm compresses and oil applied to help the perineal tissues stretch.
  • To be instructed to push in such a way to avoid tearing.
  • To tear naturally, if at all. No episiotomy.
  • To be turned onto all fours if baby's shoulders are stuck.
  • The opportunity to discuss and accept or refuse any procedure, except in the case of an emergency.

After delivery, Stephanie would like...
  • Immediate skin-to-skin with baby.
  • To wait until the umbilical cord stops pulsing to be clamped and cut.
  • To delay newborn procedures for the first hour to feed and bond with baby.
  • For newborn exams, vitamin K shot, and eye ointment to be done while baby is on her chest.
  • The placenta to detach and be birthed without Pitocin, unless an urgent need arises.
  • For baby to be evaluated and bathed in our presence.
  • To exclusively breastfeed while in the hospital.
  • To meet with a lactation consultant as soon as possible.
  • To be consulted before baby is offered a bottled or pacifier.
  • For John to do skin-to-skin if Stephanie is unavailable.
  • For John to go with baby if baby needs to be taken from room for medical treatment.
  • For baby to be given pumped breast milk if breastfeeding is not possible.
  • For all visitors to be turned away until we have had time alone with our baby.
  • For baby to be given a hearing screening test before leaving the hospital.

In case induction is necessary, we would like...
  • To try natural, non-chemical induction methods first, such as walking, castor oil, or nipple stimulation.
  • If natural methods fail, to try the cervical cream before Pitocin.
  • If Pitocin is required, for it to be administered following the low dose protocol and increased in intervals no closer than every 30 minutes, allowing Stephanie's body an appropriate amount of time to adjust and react to each dose increase.

In case of a c-section, we would like...
  • The surgery to be explained as it happens.
  • Stephanie to be conscious with at least one hand free if possible.
  • John and Amy to be present at all times.
  • For double-layer sutures to be used when repairing Stephanie's uterus.
  • Our baby to have the opportunity to nurse immediately.
  • Skin-to-skin time as soon as possible.

That's all we've got for now. But I suppose we may make a few more edits before baby arrives.

Notice that our preferences are very anti-disruption. We're going to try our best to create the most calming and pleasant hospital environment possible, as keeping things most home-like and peaceful are going to help me relax. And if I'm relaxed, so, hopefully, will my cervix be! Thus, disruptions like loud noises, bright lights, large groups of docs, nurses, or med students, cervical checks without permission, and so on are big no-nos.

Also, I want to be able to move around as much as possible. Labor pains will likely not be tolerable if I'm stuck in bed the whole time. Plus, moving around helps dilation happen faster and moves baby into the best position for delivery (baby's nose facing mom's back). Win win! So up and moving I will be! Walking around, rocking in a rocking chair, standing in a shower, bouncing on a birthing ball, slow dancing with my husband, squatting... whatever it takes to make labor most comfortable and most expedient, I'm going to do it. And that's why I'd like to be monitored only intermittently, on a heparin lock if IV is necessary, and I want to avoid an epidural, as epidurals numb your legs and make it impossible to get out of bed.

For us, the key to all of it is natural natural natural every step of the way. The more natural we can be, the less likely a c-section becomes. And if I can avoid that major surgery, I'll be one happy mama. Of course, if we need a c-section, I will absolutely be open to it at the time. But the key word there is need. I'd like to do everything possible to avoid one from happening, and from my research, that means avoiding any and all interventions. It means taking my time, moving around, working with my contractions, and listening to my body.

If I do get to the point where labor has physically and mentally exhausted me and my exhaustion is preventing me from progressing, that's when I will become open to getting an epidural, and will consider it as a helpful tool in delivering baby at that point. But here's hoping I can work with my contractions to progress quickly enough that complete physical and mental exhaustion don't happen.

You'll also notice, I'm big on bonding as soon as baby is born. No matter how our little one arrives, I want skin-to-skin immediately, and hopefully a chance to breastfeed as soon as possible. Newborns are amazing. When placed on mom's tummy right after delivery, they can wiggle around, find their way to the breast, and latch on all on their own. Beautiful, right? So that's why we're delaying all the typical right-after-birth baby procedures (cleaning, weighing, vitamin K, etc.), to make breastfeeding happen as seamlessly as possible, just as it was designed to. We'll also be holding off on visitors for at least 12 hours, to establish breastfeeding and bonding and to let John and me rest a bit before entertaining guests. Call us selfish, but I think it's for all the right reasons.

Perhaps at this point, you think I'm a nutcase. So much research, so much attention to detail... How about you just let it unfold on its own, Stephanie? To which I say, welcome to my type A world. This is just me being me. This is how I prepare for something I know nothing about. I learn as much as I can and make a plan, errrr, I mean preferences, and hope and pray that I get to stick to them. Maybe it's not your approach, but it's what's best for me, my husband, and our almost newborn.

I realize I haven't explained everything here regarding our birth preferences. If you'd like more details on any of our preferences, don't be afraid to ask. I tried to hit the big ones, but realize some of the other ones, like the use of double-layered sutures in the case of a c-section, may need explanations too. Just ask. I'll explain in the comments. :)

Now let's take these birth preferences for a spin, shall we?

Just 4-ish short weeks to go!


  1. Gosh is it really only 4 weeks to go? Craziness! I'm definitely praying for y'all as the time gets closer. :)

    1. Thanks, Hannah! And yes, isn't it crazy?? Time is flying and dragging at the same time.

  2. I hate to offer advice but May I make one suggestion ( based upon our experience ) . . . have your birth preferences signed off by your doctor.. . . . your doctor, won't likely be in attendance til the very end. Also opens up for discussion withe doctor before you are in the moment & not really in a mental state to have a discussion. +++ the interesting one I put in my preferences, was for a room with a view... 90% of the birth rooms at our hospital have no windows -- ask and ye shall receive.

    1. No, this is great advice! I was wondering if I should show it to him or not since he seems to be completely on board with natural birth, but there may be a few things on our list that surprise him. Good idea! I'm glad to hear you got a room with a view. That makes me want to add "room with a tub" to my list. Most of the birthing rooms in our hospital have tubs, but a few do not. I'd be pretty bummed if we ended up in a room without. So you're right... I need to make sure to ask! I also remember you writing about getting an episiotomy and it sort of just happened before you even had a chance to say yes or no. That made me sad for you. I totally see what you're saying about making preferences clear with your doctor ahead of time.

    2. The suggestion of the signature came from our birth instructor who's also a doula. We went with an instructor not affiliated with a hospital. She was very Pro-Natural birth, Homebirth, water birth. Sadly our hospital has like a 40% C-Section rate.. so you can only imagine what they covered in those classes.

    3. Wow! That's an insanely high c-section rate!! :( Glad you found a better instructor elsewhere.

  3. It's funny that you singled out the sutures for a c section. I had one and I will have to have one for any future children and I'm curious why is that important? I don't know if I had that or not, I'll have to ask my doctor now but can you explain more?

    1. From what I understand, it's a stronger stitch, so it's less likely to burst open when mom goes into labor with future babies. It's especially helpful when mom would like to have VBACs in the future, as the uterus really gets put to work during labor and vaginal delivery and needs to be sewn up strongly. Risk of uterine rupture after c-section is pretty low, especially if it's only your 2nd c-section, but it wouldn't hurt to make sure the doc does the stronger sutures. Make that risk even lower! I hope you had them with your first, but if not, hope this helps in the future! :) Your little guy is so stinkin' cute, btw!

    2. I'm so sorry I didn't think to check back here for a response until now!! Thank you so much for explaining that to me, I will have to ask my doctor next time I see her!! Also thank you for the compliment on my son. He's a good little boy, we think he's pretty cute as well. Can't wait to see your little one! He/she will definitely be adorable!!!

  4. I have never been preggos so I can't offer anything substantial...but from personal experience with many health concerns, may I only humbly suggest, that while you are at home in the early process of labor, that you get your blood pressure checked regularly. It is one of those hidden things that can creep up on a pregnant woman and can be very dangerous if it gets too high- NOT trying to scare you, and you already are very informed so I'm sure you know this, but I just wanted to put it out there. Hugs and I really do pray that your "preferences" go as planned. :)

    1. I chatted with John about this and he assured me he'd be on the lookout for signs of high blood pressure while I'm laboring at home. Thanks for the tip. :) And also for the prayers!

  5. Boy, looks like you have this all well thought out...I've heard that babies sometimes have their own plans....I do pray it all works out and you get to bond with your little one soon!

    1. Thanks for the prayers! Little ones sure do make their own plans. That's why these are just preferences. :) What I'm learning, though, is if you desire a natural childbirth, it really does take this much prep to know what goes into it and how to avoid all the interventions. All this prep just gives us our best chances of getting the birth we prefer. Here's hoping!

  6. Actually, my favorite part of your list is the double-layer sutures. :) VERY good to have that in writing. I also love that you call these preferences... birth truly is a unique experience each time. I've been blessed so far to give birth twice, and both are quite different stories, with some preferences playing out exactly as planned and others taking rather interesting turns. My best advice is to listen to your body not just in active labor, but in the weeks leading up.. you've educated yourself so well, you will be able to really focus on your labor instead of a million unanswered questions. I remember with my first, waking up at 4am craving a Thanksgiving dinner and talking myself out of it (should have eaten!) and later, being aware that I was slipping into that focused, "non-social" stage of labor (and knowing that was normal). The research really is productive! So excited for you!!

    1. Thanks, Sarah! Listening to my body in these last few weeks -- a great reminder! I'll be sure to eat a Thanksgiving dinner if I crave it soon. :) And yes, I think that while I may not get to apply everything I've learned, the research and prep we've done will help us as I progress through the stages of labor, for sure. Just to know what's normal and such will put me at ease.

  7. How are you feeling?? Only a few more weeks to go..

  8. I just went back and read this and smiled. You sound just like me (but way more knowledgable/organized). And now HE'S HERE!!!!!!!!!!! Can't wait to read your birth story!!!!!!!!!! :) :) :)

  9. The more natural we can be, the less likely a c-section becomes. And if I can avoid that major surgery, I'll be one happy mama.It's maybe writing is great and i like this. More information's just logged in:

  10. It's basically my family appearing my family. Figuring out how That i get ready for an item I do know very little related to. That i know nearly Allow me to together with produce method, error, Setting up tendencies, together with pray together with pray that go to abide by him or her. Could be it's not at all an individual's process, however , it is actually what the heck is perfect in my situation, my husband, together with some of our more or less newborn baby follow.


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