Oh Baby Birth Plan

 

The memories and emotions a woman associates with her birth experience can profoundly affect her for the rest of her life. I’ve decided to share the details of my ‘unofficial birth plan' (or more appropriately, my intentions). I’m certainly not promoting these as my ideals of a “better way to birth”, and these are not the birth practices that I think every woman should choose for herself. These are just the personal choices I feel are right for my body, my baby and my family. I advocate for informed choice in hopes of empowering women and helping them better understand their own rights in birth.

* I hope it goes without saying that these are my preferences as long as they comply with the complete safety of both my baby & myself throughout the entire birth process.

 

Trusted Birth Support

Birth follows its own path and it may not always go as planned, but I truly believe the key to having a positive birth experience can have more to do with the support you chose than with physiology. I’ve taken great care to select a birth attendant whose standard practices of care already align with my intentions. I don’t have to plead my case to my health care provider or be concerned that my birth preferences are being considered during labor. I can’t speak highly enough about the importance of surrounding yourself with people who will greatly respect and gently encourage you during the birthing process.

Knowing who will be with me during my labor and having the chance to build a trusted relationship with them is one of the many factors that appeal to me about homebirth.

 

Honoring Slow Birth

Birth is a very intricate series of events, each one triggering the next. Anything used to force the body/baby before it's ready (both medical and natural methods of induction) can have unwanted effects and consequences. In honoring slow birth, I’m allowing my contractions to start on their own and intensify at their own pace. Birthing sensations can slow down or stop altogether for a period of time, which is a very normal and natural occurrence during labor. Your birth is simply progressing at its own biological pace.

Emotional and environmental influences are intricately tied to a birthing woman’s labor process. If labor has “stalled”, ensuring that she feels safe and secure in her surroundings can be far more productive than causing her to doubt the ability of her body and the rate of progression.

 

Internal Cervical Checks

Everything in the body works simultaneously, in so many immeasurable ways, to allow an unmedicated birth to proceed harmoniously.

I’m sure most women in labor are curious how much longer it will be until they meet their baby. One routine method used to determine this is internal cervical checks. I believe they can sometimes paint an unreliable picture of how labor is (or is not) progressing. The rate of dilation doesn’t necessarily translate to the speed of labor, and pressure of unwarranted time restraints on a laboring woman can actually further slow her progression.

Every birth follows it’s own unpredictable path and there are many healthy variations of normal. A seemingly unfavorable cervical check can be very discouraging for a mother who is working hard and needs to stay focused, and it could understandably make her more likely to accept medical intervention to get things moving along. While I’ve chosen to avoid cervical checks altogether, if you have them, I just encourage you to not place too much emphasis on the number they provide.

Increasing Risk Of Infection

Internal exams after the membranes have released also substantially increase the risk of infection. In hospital births where cervical checks are the norm, a woman is usually only able to labor naturally for 24hrs after her waters break. After that, she is commonly started on a chemical induction if she is not considered to be progressing fast enough. This is because the risk of an infection (possibly introduced by a cervical exam) may put her and her baby at risk.

*Any methods of induction (medical or natural) may initiate the sensation to push prematurely. In this case a cervical exam can help determine that a mother is not pushing into a cervix that is not fully dilated.

 

Instinctual Movement

When encouraged to move freely, it's rare that a woman will choose to lay flat on her back throughout labor. An upright position increases the diameter of the pelvis, can help strengthen contractions and open the cervix.

When encouraged to move freely, it's rare that a laboring woman will chose to birth lying flat on her back. An upright position increases the diameter of the pelvis, can help strengthen contractions, and open the cervix. It's commonly recommended to sleep on your side later in pregnancy because the weight of the growing uterus can compress the vena cava (your main vein) and decrease blood flow. Less oxygenated blood for you = less oxygenated blood for your baby, which can lead to fetal distress... one of the most common reasons for an unplanned cesarean section. Being able to move instinctively when birthing also significantly reduces the likelihood of your baby becoming misaligned or 'stuck'.

 

Eating & Drinking

Labor is very aptly named because it is a physical task that requires both strength and stamina. Restricting your food intake during labor can cause stress, nausea, headaches and exhaustion. It can also prolong labor and lead to fewer contractions that are less effective. Eating and drinking during labor, especially in the early stages, can provide you with necessary energy and help you remain more comfortable.

For suggestions: What To Eat & Drink During Labor

 

Fetoscope vs Doppler

A Doppler is a hand held ultrasound device used to detect a baby’s heartbeat. It uses continuous rather than pulsed waves, therefore emitting even higher acoustic frequencies than the ultrasound used to produce sonograms. To reduce ultrasound exposure, we’ve decided to wait until the baby's heartbeat could be detected by Fetoscope (similar to a stethoscope). I’ve also chosen intermittent monitoring with a Fetoscope during labor.

 

Pushing Without Coaching

During the final stages of an unmediated labor, women experience the Fetal Ejection Reflex. If we work with our body and only push when we feel the urge, we utilize our energy better, we’re able to work with our breath, our tissues can stretch slowly, and we drastically reduce the chance of tearing.

Coached pushing is also called purple pushing ("hold your breath and push as hard as you can while we count to 10") and it usually begins when a women reaches 10cm. Even when a woman reaches 10cm, her baby and her body can still be making final adjustments, fine-tuning to ensure that everything is aligned. If baby is not perfectly aligned, directing a mother to push when she doesn’t feel the urge can cause the baby to become further misaligned and become stuck. It is also associated with higher incidence of fetal distress.

It’s also very common for a laboring mother to experience no immediate urge to push once she reaches 10cms. This time of inner resting allows for a mother to regain focus for the journey ahead, connect with her baby, and take a moment of peace before her life changes forever. It’s a sacred time for a woman to reflect on the “place from whence we came and shall never return”.

*Epidurals may dampen the urge to push and women who receive them may require coached pushing.

 

Delayed Cord Clamping

The placenta, the lifeline that nourishes baby, offers one final surge after birth. This crucial transfer provides baby with: a third of its blood volume, oxygen to vital organs, increased iron stores, lowered risk of anemia, post-birth hormones, precious cells (red/white blood cells, immune cells, and stem cells), vitamins, minerals, and nutrients. 

The term “delayed” can vary practitioner to practitioner, and some may cut while the cord is still actively engaged in this valuable transfusion. We’ve choosing to wait to cut the cord until after it has completely stopped pulsing and lightens in color.

 

An Unmanaged 3rd Stage

I’m choosing to allow the placenta to detach naturally without actively managing it with a Pitocin injection or manual cord traction. A natural or physiological birth of the placenta is not always possible, as it can be disturbed by: medical interventions during labor, a stressful environment, lack of privacy, warmth and comfort, interrupted skin-to-skin contact with baby (that doesn’t encourage oxytocin release), and prescribed timeframes.

 

Immediate & Prolonged Skin-To-Skin

If the moments after birth are rushed, it may seem as though baby is a checklist of things that need to be done, rather than a person (and family) starting a new life. Slowing down and savoring these precious moments allows me time to meet and greet my little one, and initiate breastfeeding before weighing or measuring is done. Mama/baby skin-to-skin contact in these bonding moments helps regulate baby’s temperature, breathing and blood sugar.

*It’s common to place a newborn in a bedside bassinet or to pass them around to excited visitors, although if their blood sugar begins dropping, the most effective methods of regulating it is to place baby skin-to-skin on mother and try to initiate breastfeeding (rather than offering formula).

 

Synthetic Vitamin K2 Injection

Breast milk provides all the nutrients baby needs, although modern breast milk is low in vitamin K, and newborn vitamin K deficiency can be a result of insufficient maternal intake. Traditional cultures consumed significantly more vitamin K2 rich foods than we do today: such as fermented foods, pasture raised egg yolk, grass-fed butter and organ meats.

Vitamin K2 from high quality sources has a very high rate of transfer to colostrum, so unrestricted breastfeeding after birth (from a well-nourished mother) serves as an immediate transfusion to newborns. To avoid an injection of a synthetic vitamin K for baby at birth, I’ve been very mindful to consume foods rich in vitamin K2.

*Alternatives may want to be considered in the event of: certain maternal medications, an assisted birth (c-section, forceps, manual), or where immediate breastfeeding is not possible.

 

Delaying Baby’s First Bath

Vernix, the white, waxy substance covering a newborn's skin provides a barrier in utero and acts as a lubricant during labor. These immune protecting oils offer antibacterial and temperature-regulating properties to a newborn and help inoculate baby with healthy bacteria from its mother after birth. We’ll allow them to absorb for a minimum of 12-24hrs which can be highly protective. After the birth of my firstborn, my husband and I also avoided washing ourselves with scented soap in the early days to allow our babe to familiarize himself, become bonded to and comforted by the natural scents of his parents.

 

carley