Most published “birth plans” provide a menu of options with check boxes for things that you want during labor and delivery. These forms suggest that having a baby is like having a meal at a smorgasbord, pick what you want for each course the price is the same. However, when it comes to labor, some of these “menu items” are more expensive (have more risk) than others. Below we provide you some information about our common practices and reasons for them. If you have any special requests or would like to discuss any of these issues further, please make a note of them below and we will discuss them with you.

 

Environment—if you would like to have the lights down, or bring/play your own music, that is usually acceptable and is simply a matter of conveying your desire to the staff caring for you while on Labor and Delivery. During the actual delivery or after the delivery if stitching is required, some lighting is necessary.

Visitors—Your partner is welcome throughout your labor and delivery unless an emergency cesarean section is necessary and you have to have general anesthesia. In addition, depending upon your wishes, their maturity, the room size and your condition, other family members/friends are usually allowed to attend the birthday party.

Pain management—Except in specific circumstances, we usually leave the type of pain management up to you. Available options include, Lamaze-type techniques (no medications), IV narcotics and regional anesthetics (such as an epidural). All options for pain relief have their own risks and benefits. We base the type and timing of pain relief methods on your wishes and individual situation.

IV—We strongly recommend that you have an IV in place during labor so that you can more quickly be cared for in the event of an emergency. It is common to attach the IV to tubing and give some IV fluids but this can usually be limited if you desire.

Food and Drink—We recommend limiting intake to clear liquids and hard candy so that your stomach can be relatively empty. If an emergency delivery is necessary and you have to have general anesthesia, it is much safer for you if your stomach is empty.
 

Monitors—We usually do continuous fetal monitoring once you are admitted to labor and delivery. If your pregnancy is uncomplicated and the initial fetal monitoring is reassuring and there is adequate nursing staff available, it may be appropriate to go for periods of time without fetal monitors in place. Usually the fetal monitors are placed on your abdomen over your uterus. If additional information is necessary we sometime put monitors directly on the baby or inside your uterus.

Labor positions—As long as we can monitor the baby often enough to be sure that the baby is OK (varies with the situation), you can move around the room if you would like.

Delivery positions—Most women deliver while lying on their back or side and most providers have the most experience delivering babies from this position. If you would like to deliver in an alternative fashion, please let us know.

Episiotomy—We do not routinely cut episiotomies. If they are performed it is usually because we need to get the baby out quickly.

Forceps and Vacuums—We do not use forceps or vacuums without a reason. Vacuum or forceps assisted delivery is recommended when your cervix is completely dilated but the baby needs to be delivered more quickly than you are able to push the baby out or because you have been unable to make enough progress on your own. If forceps or vacuum is recommended it is because the provider believes that the potential benefits of the procedure outweigh the risks.
 

The umbilical cord–If you desire, your partner can cut the cord unless, the baby needs extra help transitioning to life outside of the womb and we have to move quickly.

Bonding—You can let us know at the time if you prefer to have the baby placed on your abdomen right after birth or have the baby cleaned off first and then given to you. Unless there is a medical reason to do otherwise, we keep the mom and baby together after the delivery.

Feeding—Usually the best time to begin breast-feeding is shortly after birth. We support and encourage this practice.

Medications for baby—We typically give the baby a shot of vitamin K in the thigh and put some antibiotic ointment on the eyes within the first half an hour after birth. These medications help the baby’s blood to clot properly and decrease the risk of eye infections that the baby may acquire during the birth. If you would rather the medications be given later or not at all, please let us know.

Please share with us any of your concerns or special requests.
 

Remember in the event of an emergency regarding your health or the health of your unborn baby, we will do our best to keep you informed but we may need to modify your birth plan.