Posts Tagged ‘childbirth’

Birth Plan

Written by Elena @The Art of Making a Baby. Posted in My Pregnancy, PREGNANCY

PLEASE READ: I can’t believe I have to make this disclosure but after a lot of initial unsolicited and close-minded (and some helpful and nice) input on the hospital bag post, I’d like to say this:

This is MY birth plan. I am NOT interested in what YOU think my birth is going to be like. Nor what YOU think my hospital will or will not allow, nor what YOU think I can or cannot do.
I did run this whole thing past my OB who delivers exclusively at the hospital I’ll be in and got an approval and signature on everything with a few maybes, with his cell phone number to call in case something isn’t working out.

That being said, you’re welcome to share your experience of YOUR birth and birth plans, as well as give advice based on FACTS pertaining to MY birth specifically, as long as you have read previous posts and know exactly where I stand (in other words, you aren’t a first time visitor who seems to think that they know anything about what I want or need).
I’m very interested in any hypnobabies/hypnobirth birth plans and how things worked out.
Before commenting, please read Childbirth training post, if you haven’t before. Thank you!

I am quite open to many things if need be, however this is my best case scenario of how I’d like things to go in case of a normal uncomplicated and not drawn out labor.
My awesome OB agreed pretty much with everything and as he was going through the points, he kept going “That’s how it normally is” to almost every point.

Obviously, this plan is going to have to be modified, if Alexis doesn’t show up by Thursday and I have to go in for an induction. A few things on here will go straight out the door in an induction situation.
{And obviously, this isn’t the format I used for the actual birth plan. This is just a breakdown. }

BIRTH PLAN

Note: since I’ll be doing hypnosis for relaxation, my husband will be the one communicating with the nurses most of the time.

  • Minimum personnel in the room. No interns or students in the delivery room.
    I’ll be doing hypnosis so I want it as quiet as possible. They can teach kids on someone else. {people relax, it is said as a joke. My own good friend and MIL are both nurses, recently out of training. I just won’t be able to concentrate on hypnosis with people in and out of the room}
  • No regular cervical checks. I don’t want to be informed of progress, either.
    I’m really digging the emotional stages of labor and see them over and over again in birth stories I read, so I would rather go by that since it’s more accurate than dilation. Funny story: my sister who gave birth in Russia 18 years ago told me about her experience. She basically had painless contractions that started at 8pm. At 12am (4 hours later), they suddenly picked up and she was screaming in pain. They checked her- 4cm. No way she can labor for hours like that she thought (there were no epidurals available). 30 minutes later- she was 10 cm and ready to push. My nephew came out with 4 pushes. Another great example of how emotional stages of labor are way more indicative of progress than dilation ( if you don’t know what I’m talking about, you can read it in Bradley Book)
  • No IV unless necessary (hep lock is fine).
    Truth be told I really don’t even want a hep lock. I don’t know how comfortable or uncomfortable I will be and I’d really like to avoid have a needle attached to my arm. Or being pumped full of fluids. But I realize I might not be able to not have either. I am, however, open to an IV, if for some reason, I am unable to hydrate properly and/or my labor is taking a long time. Fluids have its use- that’s for sure- just not as a routine thing in every labor. This was the first item that doc said we might have an issue with the nurses over.
  • No drugs whatsoever (including induction drugs, unless we agreed to them prior to ).
    I don’t want any painkillers, no Demerol or anything of that kind. I’d go for an epidural if I can’t handle the intensity of childbirth before going for other drugs.
  • No Cytotec if induction is necessary
    OB said they don’t ever use it anyways.
  • No amniotomy.
    Really needs no explanation. My doc agrees.
  • I’d like to be able to drink liquids, eat easily digested foods (fruit) during labor, if needed.
    Doc insists that I will not WANT to eat once I’m in active labor. Im not disagreeing but I’d like to decide for myself. I’m not planning on eating anything but easily digested foods, like fruit or juices, or maybe those bars I packed in early labor.
  • No continuous fetal monitoring. 20 minutes on , 20 minutes off is fine.
    This according to the doc is going to be a hard one. The funny part is I totally understand why they want to monitor, however I don’t want to be tethered down. I might be perfectly comfortable in bed and then sure bring it on. But based on everything I’ve read that’s usually not the case. So we are going to allow 20 on and off initially because I totally get why they want it and sort of play it by ear otherwise. If I am comfortable using hypnosis in bed or where the monitor can reach, I am not opposed to constant monitoring, but if it’s going to limit the type of relaxation techniques I can use, then it’s going to have to go. OB wasn’t happy about it, because he gets to track all his laboring patients on his iPhone ( how cool is that?), but he’s too sweet and caring to say no.
  • No epidural unless we specifically ask for it ourselves.
    This is sort of a no-brainer, but I just don’t want to be asked if I want an epidural until I request it myself.
  • No loud noises or push coaching.
    That only refers to initial pushing. Once the head is crowning, my OB will be directing my pushing to prevent tears. I don’t tend to need a lot of loud cheering on and we don’t want the atmosphere to be crazy loud, so none of that “PUSH! PUSH PUSH!” for me. On the other hand maybe I’ll be surprised and that’s exactly what will get me going.
  • I would prefer not to spend any time lying flat on my back, including during pushing stage.
    This one is non-negotiable! Half the hospital births I’ve seen they have women lying on their backs. 45 degree angle is fine, on my back- no!
  • I’d like to push in a sitting squat or whatever position I find comfortable.
    This one I’m really curious about what position I will find best to push it. No way to know until you get there :)
  • No episiotomy.
    Luckily doc agrees.
  • During the pushing stage, I would appreciate warm moist compresses and perineal massage to reduce risk of tearing.
    It’d be really cool if doc remembers to do that. Otherwise hopefully hubby will be in a gathered enough state to remind him.
  • No pulling on baby’s head. I would like to push her out myself.
  • Please delay cord clamping for at least 1-2 minutes. The cord clamping thing was initially “until it’s done pulsating”. After discussing it with the doctor he said that the longer you keep the cord unclamped and the more blood gets in (plus he brought up something to do with the baby being above mothers chest or something like that), the more bilirubin needs to be broken down. So it’s a fine balance between “yes you want the baby to take as much blood as possible to prevent anemia but at the same time you might run the risk of severe jaundice that’s a lot more dangerous”. To be honest I haven’t had time (or more like desire) to look up and see if what he’s saying is correct. He is a really caring doctor so I doubt he’d be saying something that it’s partially true. So we decided to let the cord pulsate for a few minutes and then clamp it. That way we get some extra blood into Alexis, but don’t run a big risk of jaundice.

BABY PLAN

  • We will provide blankets and will dry the baby ourselves {Actually, Andrew will as I’ll be “busy” with other things)
  • Please allow us time to get to know our baby and breastfeed (1-2 hours) before any newborn procedures.
  • All newborn procedures to be done in the room
  • Please no baths
  • Please keep low voices and be gentle
  • Please no eye ointment and no Hep B vaccine.
  • ABSOLUTELY NO formula, sugar water, water.
  • NO artificial nipples (pacifiers or bottles)
Hope this helps some of you who are in the process of writing a birth plan. I will have to change it if induction is necessary by Thursday. I don’t think I’ll post the updated plan since there’ll be far more important things to do. What I will do, however, is write a post on how it worked out for us. I assume, things won’t go exactly as we want, so concessions will have to be made, and it’ll be interesting to see how it all works out.

Evolution of My Attitude Towards Childbirth

Written by Elena @The Art of Making a Baby. Posted in My Pregnancy

My attitude towards labor and delivery has changed DRASTICALLY from the time before I got pregnant, then pregnant, then VERY pregnant, to NOW.

Before I was pregnant, birth was a hypothetical painful dreadful experience that we all have to deal with one day. It’s not something I wanted to think about at the time.

Once I got pregnant, that attitude changed to “yes it’s going to be horrible, but whatever it takes to bring my little baby into this world”.

After I watched some less-than-PG13 youtube videos of birth, I was horrified and was CONVINCED that the only way to do this was to “hook myself up to an epidural and try not to look down”. Once the fear passed and I got used to the idea of birth and the imagery of it, I was dreading it less, however I strongly felt that there was no reason for me to try natural birth, since we have things like epidurals that will keep you comfortable with minimal risk. I don’t know my pain threshold and I didn’t want to exactly test it ( I still don’t) and with everything that I read about an epidural, while I’d love to avoid it, I  just didn’t feel like the side effects justified going through so much pain.

There are some things that I can be strong about and blow people’s mind with my willpower, and there are others that I just don’t think I can do (running is a great example). We all do what we know we are capable of and I did not think I was capable of going through the pain of childbirth without an epidural. I also knew I definitely didn’t want any pain relievers aside from an epidural, so I figured I’d deal with the pain until I could get an epidural and hopefully I’d get it around 5 cm, so  it wouldn’t stall my labor.

I continued reading books about birth and relaxation techniques. I read the Bradley book along with the Bradley Partner book and found the information invaluable but not enough to change my mind about the epidural. It did help me understand the process better and that it’s natural and the mechanics of contractions and not to fear them as much but to relax during them. It really really helped me understand what really happens when the uterus contracts. I felt like that knowledge would take me to my 5 cm until I could get an epidural. I also loved reading about the emotional signposts of labor rather than going by dilation to judge the progress. It just made sense. {I’d be very curious to hear from any of you who knew about the emotional signposts going into labor , whether you recognized them  and whether it helped you know where you were at}

However, nothing in Bradley method made me think that I would want a natural birth, nothing promised it’d be roses and champagne and the best experience of my life, so I still wanted an epidural, BUT now I was willing to have a wait-and-see attitude. I wanted to see if I could do it naturally with the tools the Bradley book provided me and if not, I was perfectly ok with an epidural.

A few weeks later, I was reading one of the million pregnancy books I read weekly and they mentioned hypnobirth. I had been seeing the name “hypnobirth” and “hypnobabies” as ads on random birth related websites, but I always steered clear of them because 1.) I thought “hypnobirthing” had something to do with laboring under hypnosis and 2.) “Hypnobabies” just sounded strange… Babies under hypnosis? I didn’t even realize it was a labor technique. What do babies have to do with it?  I didn’t even want to look into it- I thought it was weird.

That was until one of my books mentioned hypnobirth saying that it’s a relaxation method for unmedicated birth and that some people swear they have painless “pleasant” experiences. I was intrigued. I instantly jumped on my iPhone and looked up some information. There was a lot of “sales pitches” online, so i was still skeptical even after I read about how it works. That was until I decided to look for videos on youtube, in case someone filmed a hypnobirth. Of course, someone did and I just kept watching hypnobirth video after hypnobirth video and I couldn’t believe that these women were completely relaxed, not screaming, not writhing in agony ( which is what we see everywhere else), not blaming their husbands for knocking them up (lol). One woman was so relaxed that her midwife completely missed the baby slipping out of her with 1 single sound “Agh”!

So the days of watching hypnobirth videos and researching began….

If I can have a natural birth without the agony that everyone else promises, and all you have to do is put some work and preparations into it (hello? It’s my specialty),then I am all for it!

To make a long story short, I settled on Hypnobabies program. If you know what hypnosis birth is all about, then skip the next part, but I wanted to write a bit about the concept of these programs for future mamas.

Basically, the concept is the following ( whether it’s hypnobirth or hypnobabies or any other hypnosis program):

It is a self-hypnosis technique, where you get yourself into a state of relaxation and “hypnosis” while staying completely lucid and awake. You feel the same, you feel normal, just really really relaxed. It is achieved via a lot of training and practicing. According to these programs ( and many birth stories I read), childbirth doesn’t have to be painful. It is often made painful by the fear-tension-pain cycle ( which makes sense based on the stuff I read in Bradley books on how the uterus contracts). We have been conditioned to think that childbirth is super painful and it is what we expect and thus it is what we get. When a contraction comes in, we dread it, tense up (which is a completely natural reaction), make uterus muscles work harder, pull harder, creating more pain than we need to. If you fully relax your body, you will feel pressure, discomfort but not pain. However, this full relaxation doesn’t just come easy. It requires weeks and weeks of practicing, concentration and most importantly weeks of changing your attitude towards what childbirth SHOULD BE like.  Not expecting pain, but expecting tugging pressure sensations.

I did find it very true that just the simple expectation of pain (fear) makes you so tense and it’s such a normal reaction you don’t notice it. It first rang true with me when we started doing perineal massage (more on that later). Fighting the fear is really really hard. I’m sure anyone who has gone through “painful” contractions will tell you how you start DREADING the next one.

All this made sense to me. I was still a bit skeptical, but I was convinced that if I had any chance at unmedicated childbirth, this is it and I might as well give it a try. Oh and there are people that undergo surgeries with hypnosis techniques without anesthesia (those that can’t have anesthesia), so if that’s not an argument to give this a try, then I don’t know what is.

Next came picking the program… from what I understood Hypnobirth was the original hypnosis based birthing program with a book and a CD and Hypnobabies is a refined hypnosis childbirth class that takes you step by step to learning how to relax using self-hypnosis (you can buy the whole home study package here). It is much more expensive, but very convenient in how structured it is. I went with Hypnobabies because I didn’t have time to mess around ( I think I was 26 weeks or so).

So I’ve been working this program for almost 10 weeks now and my attitude towards childbirth is very different now. I am looking forward to it, I am more or less confident in my ability to handle it, I am DEFINITELY NOT afraid of childbirth anymore. The realist in me keeps wanting to continue being skeptical about the efficiency of this program, however I am set on following the program, and doing what it says, believing what it says and not second guessing myself  or over-analysing everything (which is hard). One of the big parts of the programs is staying away from negative imagery and stories about childbirth (because they perpetuate that fear-tension-pain cycle) and truly believing that it’s going to be a wonderful experience. And that’s what I’ve been doing.

Obviously, I haven’t gone through birth yet to tell you whether this program is effective or not, whether it worked for me or not, but I feel that training and preparing is the least I can do to hope for a more pleasant experience.

This is getting to be way too long of a post, so I’ll stop right here and will have to continue in another post about the training that I’ve been doing, what it entails and other non-hypnosis preparations for childbirth, our birth plan (wants and “do-not-wants”) and our baby hospital plan.

 

Resources mentioned in this post:

Natural Childbirth the Bradley Way: Revised Edition

Husband-Coached Childbirth (Fifth Edition): The Bradley Method of Natural Childbirth

Hypnobabies Home Study Course for Expectant Mothers Plus 2 Bonus Cds

HypnoBirthing: The Mongan Method: A natural approach to a safe, easier, more comfortable birthing (3rd Edition)