Confession: talking about birth is my favorite thing, hands down. The more details the better!! Give me the blood and guts (too far?), the raw emotion, the details of pushing, ALL. OF. IT. Don’t leave anything out, because there is no such thing as TMI when it comes to birth.
As a labor and delivery nurse, it’s a good thing that birth is my passion; otherwise, you wouldn’t want me in the room with you!! But, before we talk about labor, we’ve got to talk about birth plans.
Most nurses have a love/hate relationship with birth plans, and this is why: most are reasonable (love), but then there’s that one that is totally wonky and unrealistic (hate). This is not to say that we don’t want you to have a birth plan, because we do!! We love mamas that are prepared and have a general idea of what they’d like their labor and delivery to look like. But, know this: no one can control how your body and your baby respond to labor. While we will do everything it takes to make your birth beautiful and exactly how you imagined, there are factors that are out of our control.
So, my goal is to give you some do’s and don’ts for your birth plan, because they are absolutely a good idea. Here we go!
Research the hospital you plan to give birth at. This is key, because every hospital varies with its policies and procedures. I work at a small-town Birthing Center that is part of a larger network of hospitals. My specific unit has completely different policies regarding labor than the bigger hospital’s OB unit. As a pregnant mama, it would be helpful to know what your hospital’s typical allowances are so that you’re prepared during and after labor. Schedule a visit to tour the unit; write down questions beforehand so that you don’t forget. And think about attending a birthing class to get more information!
Tell us who you want in the room. It’s always helpful to know ahead of time who you’re planning on having in the room with you (hubby, mom, kids, doula, photographer, etc.). You may change your mind as things progress, which is ok, but your labor nurse is your advocate. She’s the one who will talk to the doctor about your wishes and also the one who will kick your mother-in-law out of the room if she’s driving you nuts.
Include your plan for pain relief. This is always helpful for your labor nurse to know ahead of time so that she can plan accordingly. Most hospitals offer various options, including the shower, tub, nitrous oxide, IV pain medications, and epidurals. Ask about your hospital’s guidelines regarding each of these so that you’re not pushing for something that just isn’t possible. (For example, if you are on Pitocin or having a vaginal birth after a Cesarean Section, you won’t be allowed in the tub for numerous reasons. BUT, in most cases, you can get in the shower. Know your options!!)
Tell us what medications you do or don’t want administered to your baby. This is helpful because two of the medications below are given in the first several hours after birth. If you choose to forego any medications, please don’t be offended when we provide appropriate education, as it is our job and responsibility to educate each mama about the benefits and risks.
Medications to consider:
Erythromycin. It is a gel that is administered in and over your baby’s eyes to prevent blindness that may develop from a gonorrheal infection. (Breast milk/colostrum may also be utilized, so some may choose to forego this medication.)
Vitamin K. This is a shot that your baby will receive in his or her thigh to prevent bleeding after birth. Babies are born with a decreased clotting mechanism, and may subsequently develop a bleed as the journey through the birthing canal is tight and can be traumatic. (Expect to sign a declination for this medication if you choose to refuse it.)
Hepatitis B. This is the first vaccine in a series of three that is offered after delivery. It was once given to teenagers, but they were often noncompliant with receiving all three vaccinations, rendering it useless. For this reason, the medical community has begun giving it to babies in an effort to protect from this disease. (There are no benefits to starting this series in the hospital or waiting until a later date. Your pediatrician’s office will also offer this to you during your newborn’s first several visits.)
Cesarean-Sections have options too. Don’t discount birth plans just because you’re having a C-Section!! There are lots of great options for you mamas to consider. Here are just a few:
Surgical Drape. Most hospitals have a see-through drape that you can request for your C-Section. Don’t worry, the “window” won’t be open the entire surgery (whew!!). The surgical staff will lower it right before the doctor pulls your baby out so that you can still witness the birth.
Skin-to-Skin. This is a regular occurrence for all vaginal births at most hospitals, but it has not yet become common during C-Sections. However, mamas can absolutely request to hold their baby skin-to-skin during the OR. This contact has so many benefits for your baby, including temperature stabilization, regulation of blood sugar, improving respiratory function, and initiation of breastfeeding. Not to mention, it is a beautiful way for you to bond with your baby, especially during a cold and controlled environment.
If skin-to-skin in the OR isn’t for you, or if your C-Section happens to be an emergency like mine was, request for your partner to do it in your place!! When the nurses transferred my daughter from the OR to my room, they immediately placed her skin-to-skin on my husband, because they knew that was important to me. To this day, Nate says that it was one of his favorite experiences and made him feel like he was a part of her transition to the world.
Your “plus one.” Unless your C-Section is an emergency, you’ll be permitted one person in the room. However, in some cases, your doctor may allow you a second if that’s something you discuss ahead of time. Keep in mind the hospital you are at, because some may have policies regarding this that are out of the doctor’s control. It never hurts to ask, though, right?
Photography. As a rule, video and photography have been banned from the OR due to medical lawsuits. However, this isn’t always a non-negotiable depending on your doctor or hospital. Talk to them ahead of time if photography is important to you, and chances are, they’ll be flexible. (You may be asked to sign a waiver if you choose to photograph during the C-Section.)
Don’t tell us you want a quiet atmosphere. Um, hello, so do we!! The last thing we want is for there to be a lot of noise ruining your concentration. And we definitely don’t want your screams scaring other patients on the floor! So, yes, we want it quiet just as much as you do.
Don’t contradict yourself. This one is important, because it’s a sure way to frustrate your nurses. For example, try to avoid saying things like, “I want my husband or I with the baby at all times, no matter what. Oh, but if we’re tired, you can take the baby to the nursery so we can sleep.” Need I say more?
Don’t act like we’re the enemy. Your nurses are for you, not against. We will do everything it takes to get this baby out vaginally, and the last thing we want is for you to have a C-section (more work for us, harder recovery for you). Plus, if not for you, we wouldn’t have a job! We want you to leave with a sweet babe wrapped in your arms, and more importantly, we want your babe to be healthy and perfect. Everything we do is for the safety and health of you and your babe, so please trust us.
Writing a birth plan is a beautiful way to prepare for labor and delivery. It’s absolutely a good idea to know your hospital and your options so that you have an understanding of what to expect. There are lots of great templates online that can guide you into a creating a birth plan, or you can simply write down the things you want on a piece of paper (for real, it doesn’t have to be fancy). I hope this was helpful in getting you started!!