Natural Birth Plan- Hospital Edition

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We made it to 37 weeks!!! Woohoo!!! 7 weeks of bedrest was harder than I thought it would be! I am so thankful to have made it this far and am now ready for baby boy to come out and play!

As you may have read, we are using a midwife, doula, and birthing at a local natural birth center, outside of a hospital, and are SO excited about it!! Before we finally reached 37 weeks pregnant, however, the hospital would have been our birthing place if I went into labor because legally, a midwife cannot be the main provider in a pre-term labor situation. That being said, being on bedrest gave me PLENTY of time to do research, start this blog, and come up with a few back up plans if we needed to deliver in a hospital. In my research, I developed a family-centered, more natural birth plan to use if in a hospital. Thankfully, I won’t need this with using my midwife, because many of these things are standard practice in the birth center.

I’m hoping this birth plan could help some of you come up with your version of your dream labor and delivery. Remember though, a plan…is a plan. Things don’t always go as planned. Be like the willow and go with the flow of things during your labor.


 

-Our Birth Plan: Hospital Edition-

LABOR

  • Call midwife as soon as contractions and labor begin for guidance. Leave for hospital as directed by midwife. If labor is allowed to progress the following will take place.
  • IV access allowed but nothing allowed to be infused unless absolutely necessary with permission of birthing mom and/or husband.
  • Eat, drink, and move freely during labor as desired
  • As few internal checks as possible
  • Intermittent fetal monitoring only as truly needed
  • All interventions should be explained and we should be given time to discuss together
  • Available to labor in tub, on birth ball, birth stool, shower, toilet, outside as desired
  • Music played as needed for distraction.

PAIN MANAGEMENT

  • NO PAIN MEDICATION WILL BE GIVEN.
  • Natural pain management to be utilized as needed: essential oils, massage, hot towels, homeopathics, tub, husband/doula applying back pressure if in back labor.

DELIVERY

  • Push in whatever position is comfortable, not on back.
  • Push with body’s prompting and with coach of midwife, not to timing
  • Free to deliver in water if desired
  • Perineal counter pressure, heat, oils- episiotomy only in absolutely emergent situation

POSTPARTUM

  • Immediate skin to skin for at least one consecutive hour, as long as baby and mom are stable. Well checks done on mother.
  • No erythromycin or silver nitrate ointment on eyes or vaccinations will be given at any time.
  • Vit K injection will NOT be given. Instead, Oral Vit K will be given by mother.
  • No baby bath given in hospital for at least 24 hours. Preferably baby’s first bath will be at home- wipe off face and yucky bits, rub in vernix. If bath is necessary for whatever reason, only organic baby products brought by parents are to be used on baby’s skin.
  • No hat put on baby unless necessary due to emergency situation where skin-to-skin with mom isn’t possible.
  • Breastfeeding as soon as baby is ready
  • Cord allowed to finish pulsing (minimum of 10 min) before being clamped, then be cut by dad
  • Placenta delivered naturally without Pitocin unless emergent. Placenta inspected by midwife/doctor to ensure full placenta was delivered without complications.
  • Circumcision will NOT be done in hospital.
  • Sitz bath as soon as possible with sitz bath herbs brought in by mom.
  • Baby will use cloth diapers (with liner) or organic disposable diapers & wipes only- all brought with us.
  • Baby will be swaddled in muslin swaddles brought by parents, not hospital blankets.
  • Family allowed to return home as soon as possible

WISHES IN CASE OF C-SECTION (IF POSSIBLE)

  • Shield lowered to see baby delivered
  • Baby is pulled out of the uterus slowly to mimic “squeezing” of birth canal.
  • Cord allowed to stop pulsing before clamping or cutting, if possible and dad cut’s cord.
  • No erythromycin, silver nitrate, vaccinations. Vit K injection only if deemed immediately necessary, otherwise oral Vit K will be given.
  • Baby goes straight to mama’s chest for skin to skin with warm blanket over baby
  • Well checks are done on mom’s chest.
  • Baby stays in mom or dad’s arms the entire time.
  • Room in with baby at all times

SICK BABY

  • Breastfeed baby as soon and as much as possible. Pump breast milk if necessary.
  • Free visitation by mother and father
  • Skin to skin as much as possible with mom and dad
  • Parents handle as much of care as possible

 

What plans do you have for your labor & delivery? Obviously, this process is a very personal and intimate experience. If you go in with some sort of plan before the process begins, you can have some sense of control over your labor and delivery experience. Know circumstances may arise that require different interventions and be ok with that. The more educated you are about the process, the safer and more relaxed you, your partner, and baby will be when D-Day arrives. 🙂

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To circumcise or not…that is the question

Congratulations! You’re having a baby boy! With having a new baby comes with what seems like a thousand important decisions you will have to make throughout your pregnancy and especially on “D” Day (Yes…Delivery Day). Vaccines…erythromycin ointment in the eyes, formula vs breast feeding, cloth or disposable diapers, soaps, lotions…the list goes on. For baby boys, you’ll have one more decision to make: whether or not you will have him circumcised.

This is 100% a personal decision and either decision is great for your family. As I was going through information researching for our little one, I realized how much information and misinformation is out there. Hence this article, that will hopefully help you and your partner come to the best educated decision possible for your little man.

6 Points to think about when considering circumcision

  1. Vitamin K & blood clotting of infants

If you weren’t aware, it is standard practice in hospital births for every newborn to receive a vitamin k injection within hours after birth. There are also risks involved in this shot. To read more, please refer to my previous article- Should My Newborn Get a Vitamin K Shot?

When considering circumcision, you are obviously cutting the body, therefor causing bleeding to naturally occur. It is very hard to find a pediatrician who will perform a circumcision without the child first having the vitamin K injection. Most do not consider oral vitamin K sufficient before performing this procedure, putting parents in a situation where they are forced to choose the vitamin k injection, even if they don’t feel comfortable with it.

2. When to do a circumcision

Most doctor’s have stopped doing this, thankfully, but for a while, many circumcisions were down within the first 24 hours after birth, which is the most dangerous time to perform this procedure. The reason being that the baby’s blood clotting factors are not properly activated yet so soon after birth, significantly increasing the risk of bleeding complications. There have also been studies done on the potential long term effects of trauma on a new born so soon after entering the world. If you choose to circumcise, the BEST time to do it is 8 days after delivery, as the Bible recommends. Not a religious person? Even though the Bible is the one who recommends the perfect timing for circumcision, science backs these directions. Each baby has their highest prothrombin (clotting factor) levels on the 8th day and then they decrease. It is perfectly set up for this day .

3. Risks & statistics of circumcision

To be honest, I had no idea the reality of the risks and statistics involved in modern day circumcision.

  • The CDC data, reported by the New York Times, showed that the incidence of circumcision declined from 56 percent in 2006 to 32.5 percent in 2009. Needless to say, it’s becoming much less popular these days. Circumcision used to be a decision parents made for their son to avoid them being teased when they got older. Fact is, just as many boys are uncircumcised these days as circumcised, and numbers are dropping of circumcised boys. As they grow up together, the discrimination factor won’t be there.
  • Up to 55% of circumcisions result in some sort of complication ranging from mild to serious.
  • Approximately 117 baby boys die in America each year due to circumcision. This breaks down to 1 of every 77 neonatal deaths. Read more here- http://www.circinfo.org/USA_deaths.html
  • For more facts, read more here- http://circumcisiondecisionmaker.com/circumcision-facts/

4. Today’s circumcision techniques VS. Bible days

Circumcision has been performed for centuries related to religious rituals. When reading the Bible, we read all about the circumcised vs the uncircumcised. If you are a Christian and trying to figure out where you stand on circumcision related to Christianity, it’s important to acknowledge that when Jesus came to the world and died for our sins (which one believes when claiming to be Christian), Jesus spoke many times about the important of the “circumcised heart”. He made a way for both Jew and Gentile to have a relationship with God and because of His ultimate sacrifice, it doesn’t matter anymore if one is circumcised physically or not. God looks at the heart.

Now that we have that part out of the way, it was interesting to me to find that circumcision in Bible days was actually much different than it is today. The Hebrew words used for the practice of circumcision are “namal” and “muwl”. In Hebrew, namal means ‘to clip’ – like one would clip the ends of our fingernails. Muwl means ‘to curtail, to blunt.’ Neither of these words mean “to cut” “to amputate” “to remove” “to cut off,” etc. There were very different words in Hebrew to represent ‘the cutting off’ or ‘the removal of.’

Back in the day, circumcision was ceremonial performed as”cutting of the blessing” – a very small slit made at the end of the penis to allow a few drops of blood to shed (or, actually, be sucked out by the mouth of the boy’s father or a Rabbi) as the blood sacrifice of the covenant. This small slit is of course very different from today in modern U.S. culture where we amputate the entire prepuce organ. For more resources and reading on this topic, visit http://www.drmomma.org/2010/07/biblical-circumcision-information.html.

 

5. The 3 circumcision techniques

The three most common are the Gomco clamp, the Mogen clamp, and the Plastibell. Here is a great video of a pediatrician explaining these techniques and what to expect- https://youtu.be/IF0_QBm7Qo0

6. Pain factor

It used to be believed that infants didn’t feel any pain. Sounds kinda crazy to me, but they also used to use leeches to suck out illness…I digress. Infants definitely do feel pain, and the procedure of circumcision is a painful one. Recent studies have proved that infants feel pain as early as the second-trimester of pregnancy. As adults, when we choose to do something we know is going to cause pain, we can prepare for it and get over it. When infants experience pain, it is a new sensation for them, and one some argue that can be brain altering. Physiologic studies indicate significant and long-lasting physiological consequences may follow painful insults in the very young, including changes in the central nervous system and changes in responsiveness of the neuroendocrine and immune systems to stress at maturity. Read more on this study here- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595204/


Oh my goodness gracious, what is a parent to do??? It’s a lot of information I know… I know many people who were circumcised with no apparent complications, and I know people who did have complications. Ultimately, this comes down to each parent’s individual decision. I hope this resource helps you and your partner make the best educated decision for your baby boy. Now you can be confident that you did your homework and made the best possible decision you could. I would recommend watching a video of an actual infant circumcision before you watch your son’s be performed just to be prepared as it can be scary for parent’s to watch. 🙂

Happy Baby Growing!!!

 

 

Plan B: Including C-Section in your Birth Plan

In the US, Cesarean Sections (C-Sections) are increasingly popular. Maybe you’ve had one, maybe you’d do anything to avoid having one, either way, it’s smart to include a c-section portion in creating your birth plan.

If you’re planning on having a natural delivery, like I am, there can be a lot of fear and anxiety with the thought of needing a c-section. There are risks involved obviously, with having your abdomen cut open after all. The beauty of c-sections and modern medicine is that they can truly save mom and baby’s life when needed. There are life or death situations in childbirth where both mom and baby would have died centuries ago without the option of c-sections. So, as “un-ideal” as a c-section may be for multiple reasons, it is still a realistic possibility. Instead of panicking when your doctor tells you that your dreams of having a natural birth aren’t going to be a reality because medical intervention is necessary, it would be much better to have a “Plan B” written out beforehand.

Thankfully, there are options that you should be aware of. When I was creating my birth plan, I came across a wonderful resource online- http://gratefulforgrace.com/. Author, Melinda Brouse, created an E-book titled, “Make the Most of Your C-Section: Prepare for a More Natural & Personalized Birth”. I was SO excited when I found this resource, because I never thought the words “Natural” “Personalized” and “C-Section” could ever go together. Her experiences and resources prove differently. It’s a wonderful resource that I recommend everyone looking into to know what your options are, even if you’re planning a natural birth. To learn more about this resource, visit Melinda’s site here- http://gratefulforgrace.com/2012/06/make-the-most-of-your-c-section/.

To give you an idea of how your c-section could be personalized, here are some bullet points I’ve put together from my own research and preferences that will be included in my birth plan in the case of c-section…

WISHES IN CASE OF C-SECTION (IF POSSIBLE)

  • Shield lowered to see baby delivered
  • Mom’s arms will not be strapped down
  • Only spinal medication will be given to numb mother for surgery.
  • Baby is pulled out of the uterus slowly to mimic “squeezing” of birth canal.
  • Cord allowed to stop pulsing before clamping or cutting, if possible and dad cut’s cord.
  • No erythromycin, silver nitrate, vaccinations. Vit K injection only if deemed immediately necessary, otherwise oral Vit K will be given.
  • Baby goes straight to mama’s chest for skin to skin with warm blanket over baby
  • Well checks are done on mom’s chest.
  • Vernix rubbed in baby’s skin instead of washed off
  • Baby stays in mom or dad’s arms the entire time.
  • Room in with baby at all times

It’s important to remember that a birth plan is just that…a plan. Plan’s don’t always go perfectly, and sometimes an emergency arises, where you will need to trust the doctors and nurses to do their job in order to do what’s best for you and baby. If you go in for an uncomplicated c-section, however, many if not most of these requests should be met with no problem. This is referred to as a family-centered c-section. Just remember to be nice with your medical staff and not to come across as demanding. This will go a long way.

I hope this resource eases your mind and helps you be better prepared for anything that could happen on your D-day, ensuring your birthing process is as personal and powerful as possible. 🙂