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Its that time now. The nine months that originally felt like they were going by so slowly, are suddenly here. All those weeks of anticipating the birth of your baby are over. Here you are: 40 weeks pregnant (maybe a little more or a little less) and its time to have your baby. Are you ready for the delivery of your baby? There are a few things you may want to make sure you have thought about. We are going to review them here.
Your Birth Plan: Your birth plan is a list of things that you want to exclude or include during labor. It can include who you want involved during your labor. This can include your partner, parent, other relatives or other children. Remember not all hospitals have the same rules regarding how many people can be in the laboring room so it is important to ask ahead of time what your specific hospital allows. You can also exclude people from your labor room such as extra staff or certain family members. Remember the delivery of your baby is a private and personal thing and you have the right to your specific wishes. Your birth plan can also include if you want to have a natural progressing labor, that is without medications like pitocin that can speed up labor. Remember this can only be done if your labor is uncomplicated. If you have a high risk labor or if the baby is in distress, the birth plan will be altered by the doctor of other health care provider that is taking care of you. Birth plans can be long and detailed or simple and easy. It is up to you.
What to bring to the hospital: Basically you can pack as if you are going to be away for a few days. Remember to bring toiletries such as soap, deodorant, etc. Bring your ID and Insurance information. Take any special paperwork (eg. pregnancy passport or ACOG papers) that you may need that includes information about your prenatal care, especially if you are delivering at a hospital that doesn’t have your record. Other items to remember: toothbrush, pajamas, slippers, hairbrush, change of clothes, bathrobe, extra underwear, socks, pony tail holder, chap-stick, lotion, nursing bra, nursing pads, cold pack, camera, take-home outfit for baby, something to read, snacks for your partner or labor coach, camera and cell phone chargers.
Be aware of what can happen: Be sure to educate yourself on different things that can happen during labor. This can be a lengthy list but I will mention the most common things here.
- You may or may not get an IV. Most hospitals require this especially if you are being induced or receiving an epidural. Baby monitoring can be continuous or intermittent depending on your situation. If your labor is uncomplicated and the baby is doing well, you can ask for intermittent monitoring so that you can move around and walk as you please.
- The pain can become quite intense and it is important to know the different options that you have. For some women, simple relaxation techniques such as breathing exercises, hot and cold therapy, meditation and relaxation may sufice. Other non-traditional options include water immersion, reflexology, and hypnosis. The presence of a support person or doula can sometimes help with strengthening the techniques you might have already learned in child-birthing class. Other women may opt for an epidural for pain relief. Epidurals are quite effective at controlling labor pain and are long-lasting so they can used throughout labor. Spinals are more short-term and can be used right before delivery. Other medications such as narcotics are also effective but should be used with caution because they can be passed to the baby.
- If you are being induced and your cervix is not soft or preparing itself for labor, the health care provider may consider giving you dinoprostone (known as Cervidil) to help prepare your cervix (called ripening). Once you are in active labor (defined as more than 4cm), you may require only pitocin to help progress your labor. An alternative to dinoprostone is using a foley catheter balloon that is inserted into the cervix, inflated with saline, and is then kept in place and monitored. It is removed once the cervix has responded.
- Sometimes things don’t go as planned and important decisions must be made such as why and when a C-section is indicated. Common reasons include changes in the baby’s heart rate, failure of progression (meaning the cervix stops dilating before 10 cm), arrest of descent (the baby’s head never comes down low enough so that a vaginal birth is possible), a pelvis that is too narrow and a baby that is too big. There are also other reasons that a C-section may be preformed such as pre-eclampsia and other life threatening conditions.
Care of the Newborn. Whatever method was necessary, whether vaginally or by C-Section, the baby is here. Some essential things to know about your newborn will be outline here.
- Feeding your newborn by breastfeeding or formula is up to you. Breastfeeding is encouraged by health care professionals because allows the baby to obtain important antibodies to prevent infection and also for helping the baby acquire natural defenses against certain diseases. Breast feeding can be done “on demand” or whenever your baby seems hungry usually every 2 to 3 hours. It has other advantages such as mother/infant bonding, easy to digest and easily available. Getting a good breast pump such as Philips AVENT BPA Free Twin Electric Breast Pump will make it easier for you store some of your milk. Remember if you are on certain medications or have certain infections, breastfeeding may be not be possible. Breastfeeding is not for everyone so whatever decision you make its important that it fits your lifestyle.
- Picking a formula may seem like an easy task at first but sometimes you baby may not tolerate certain formulations and you may have to switch to other preparations. For example, if your baby is lactose intolerant, a soy formula might be in order. If your baby is “gassy” or “colicky”, easier to digest formula maybe needed. If your baby is easily constipated, low iron preparations are available. The amount of formula to give and how often to give it, depends on the baby and changes as the baby grows. In the first week 1 to 3 ounces every 2-3 hours may be enough but this might change as the baby gets older. Remember to look for signs of hunger such as sucking or turning towards a bottle or your fingers if you gently stroke the baby’s cheek. Crying is usually a late sign of hunger.
- When its time to leave the hospital, make sure you have appropriate clothing for baby, try not to overdress your baby. Bring a blanket to use in the car or stroller if the weather changes or becomes colder.
- Your health care provider may ask you to come back in 2-3 days to check the baby. A pediatrician can be picked while you are pregnant or maybe selected at the hospital at the time of delivery.
- Baby’s first bath can be given anytime during the first week of delivery. Usually the first few baths can be a sponge baths, especially if the umbilical cord has not fallen off yet or if the navel/circumcision has not healed. If you are ready to give your baby a tub bath, make sure you have an infant tub that has netting or a soft area that the baby can feel comfortable in. Use warm water and wash the baby’s body first, leaving the hair for last so the baby doesn’t get cold. Use unscented soaps that are tear free. In the first few months, there are many soaps that good for both the hair and body.
- The safest place for a newborn to sleep is in a bassinet or co-sleeper next to your bed. There are many views on co-sleeping or sleeping in the same bed as the parents. Many parents co-sleep because they are breastfeeding and sleeping together facilitates feeding. Other reasons for co-sleeping are bonding and feeling close with baby. The American Academy of Pediatrics advises against it because it raises the rate of SIDS (Sudden Infant Death Syndrome).
If you have any specific questions about your labor and delivery or your newborn, please contact your doctor or health care provider.