Thinking about your birth plan
All mothers-to-be are curious about child birth. Read as widely as you can from early on in the pregnancy and discuss the birth with your partner, midwife or birthing partner before formulating a ‘birth plan’ or description of how you would like the birth of your baby to progress.
Of course, given the many contingent factors, the birth may not happen at all ‘according to plan’. Relax; the time spent exploring and planning the birth will help you know your options, as you’ll need to be flexible.
First stage of a natural birth
A natural birth (where you are not booked in to your hospital for an induction or cesarean section) will begin with contractions of the uterus. There may be some preparatory contractions which start and stop for days or even weeks before the birth – these are called Braxton Hicks contractions – but in first stage contractions will be sustained and regular over a period of time. How long this period lasts, and how quickly your contractions build up to active labor depends on the individual.
Research suggests that everything from your level of fitness and whether this is your first natural childbirth to how worried you are about the birth impact on your contractions
During the first stage you are likely to be at home, or not confined (by IVs or fetal monitoring devices) to your room at the hospital. Walking, gentle squats on a birthing ball or moving in a water bath are recommended for this stage as movement stimulates the uterus. Attending prenatal classes in the weeks before the birth will allow you to practice movements which loosen your pelvis and help move the baby into a good position for birth. Classes will also help you think about what position you would like to be in when you deliver the baby, whether you are happy lying in bed, or would prefer to be squatting or standing supported by your partner or birth partner.
Pain relief options during the middle to the end of the first stage will depend on whether you are at home or in the hospital. At home, your midwife will advise you on natural pain relief to compliment your body’s own pain threshold. Massage, hypnosis and water baths may all be options you can discuss with your midwife and birthing partner. In the hospital, you may be able to choose medical pain relief, such as an epidural, nitric oxide (gas & air) or other forms of pain relief such as Pethidine.
Your birth plan should detail how you feel about pain relief, movement, delivery position and birthing partners. It should also indicate what sort of mood you would like to create in the room; would you like the lights dimmed, prefer silence or like a particular type of music to help you through?
Second stage of a natural birth
Once your pelvis has widened or fully dilated, powerful contractions begin to propel the baby down the birth canal. You may feel the need to ‘bear down’ at this stage or you may be prompted to do so by your midwife. The length of this stage is also dependent on many factors; what kind of pain relief you have had, your levels of exhaustion, worry, and the position of the baby.
With this in mind, it’s important to make some decisions about the actual birth of your baby, and the delivery of the placenta beforehand. If you have your partner present, for example, would they like to help the baby out or cut the umbilical cord? If you need a cesarean section, would you like to hold your baby before he or she has been cleaned or the cord cut? Would you like to breastfeed your baby immediately?
Your partner and birth partner
Some husbands or partners feel confident to act on behalf of their laboring partner, others may prefer to defer to a midwife, birthing partner (your mother, sister or friend) or a doula. Some first time moms and dads prefer to use a doula on their first childbirth, not only for emotional and physical support, but also because doulas know what to expect and can act as an experienced advocate for how you would like your birth to progress.
Discuss both options with the people who will be caring for you during birth, so that you can make a plan which works for everyone.
Expect the unexpected
Your birth plan will also help you explore unexpected turns in your labor, such as premature babies (who come earlier than expected), breech babies (who are positioned feet or bottom first instead of head first and as such are harder to deliver), labor complications which may result in a cesarean section (or c-section), or overdue babies. Anticipating and writing down how you would prefer these situations to be handled allows you time to investigate the options.