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Making a Birth Plan: Is That Why They Call It Labor?
Author: Dr. Anna Kaplan
As your pregnancy progresses, you will be thinking about the actual birthing process. You may be dreaming of a simple and natural delivery, and you may also be afraid that something will go wrong. Everyone has thoughts about what a perfect delivery would be. And every mother-to-be has fears about the end of the pregnancy, about labor, and about the health of the baby.
You could say that the ideal for most prospective moms is a normal vaginal delivery, probably in a birthing center with a bedroom-like, comfortable, delivery room. Most would also like the practitioner that has been following them through their pregnancy be the one to deliver the baby.
Hopefully you have found an obstetrician that you like, and you have discussed whether she or a colleague might be the one to deliver your baby. Perhaps a midwife is going to help with the delivery, either at a birthing center or hospital. A home birth is also possible, but you may have to look a little harder for a healthcare provider who will help you.
You should make a birth plan, but remember that sometimes a plan cannot be followed.
If you want a completely natural childbirth with no medication, you may have picked a midwife or you may communicate this to your doctor. Ther are many ways to manage your labor pain, including breathing techniques, such as Lamaze and Bradley. There is also yoga, hypnosis, and calming music. Your partner can help you as well with massage and counter-pressure. You can walk, lie down, or find any position that increases your comfort. You can even have many family members with you. In birthing centers, you can often take a relaxing shower or even a bath. Water births are available in some birthing centers. Giving birth in a tub is supposed to be relaxing and natural for both the baby and the mother. If you want a water birth, you need to make sure your midwife or obstetrician is comfortable with your choice.
All of these choices can be fine if you have a low-risk pregnancy, if you yourself are healthy, and the labor proceeds without any problems.
Talk to some moms who have delivered this way. If you speak to enough women, including your friends and relatives, some of them will tell you that when labor got bad they wanted the pain medicine, NOW! It's a joke you will see in television and movies, women in the active stage of labor screaming at their husbands and demanding pain medicine. The truth is that labor pains are called pains for a reason. Labor is long, exhausting, and very painful. If you want pain relief, you should not feel guilty. But if you want all those choices available, you need to be in a hospital with an obstetrician or a nurse midwife who works with an obstetrician. To get an epidural, which is probably the best pain control you can get, you need an anesthesiologist in the hospital. In some places, you have to speak with the anesthesiologist before you go into labor.
Labor pain is mainly from the contraction of the uterus, but also from the pressure of the baby as he or she moves down the birth canal. In early labor, when the cervix is slowly dilating, you can usually be up and walking. Pain medicine at this stage is often narcotics by vein or injection into muscle. This may make you a little sleepy, but it will help take the edge off the pain. Later, during active labor, an epidural may be your best choice. The anesthesiologist numbs a spot on your lower back and uses a needle to advance a small plastic tube into the space around your spinal cord and its coverings. He or she will then put a tiny amount of anesthetic and/or narcotic directly in. The tube stays in place so that more medicine can be added as your labor continues. Depending on what medicine is used and how perfectly it works, you may not feel your contractions. Or, you just may feel the pressure, but not pain. This does sometimes slow labor, but it is easier to tolerate. In the end, you can still help push out the baby. You are wide awake, and essentially none of the medicine has gotten to the baby.
You can continue with your labor plan. Maybe you want your husband to cut the cord, and then you want your baby placed on your chest. As long as you and the baby are well, the plan worked.
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