Birthing Choices

Dec 15, 2010 No Comments by

From start (when to conceive) to finish (how to deliver), pregnancy these days is full  of personal choices. When it comes to birthing that baby, the array of options is dizzying, even in a hospital setting. Leave the hospital and there’s yet more to select from.

Though your delivery preferences shouldn’t be your only criteria in picking a practitioner, they should certainly be on the table. The following are among those birthing options that  you can consider these days. Ask your potential candidates about their feelings of any of these-or any others -that appeal to you (keeping in mind that no firm birthing decisions can be made until further into your pregnancy, and many can’t be finalized until the delivery itself):

1.Birthing Rooms. The availability of birthing rooms in most hospitals makes it possible for you to stay in the same bed from labor through recovery (instead of laboring in one room and then being wheeled into a delivery room when you are ready to push), sometimes even for your entire hospital stay, and your baby to remain at your side from birth on. Best of all, birthing rooms are cozy and comfy.

Some birthing rooms are used just for labor, delivery, and recovery (LDRs). If you’re in an LDR, you(and your baby, if  he or she is rooming in ) will be moved from the birthing room to a postpartum room after an hour or so of  largely uninterrupted family togetherness.  If you’re lucky enough to be in a hospital that offers LDRP (labor, delivery , recovery, postpartum) rooms, you won’t have to do any moving at all. You and baby-and in some cases, dad and even siblings- will be able to stay put from check-in to check -out.

Birthing rooms at some hospitals are available only for women who are at low risk for childbirth complications;  if you don’t fit that profile, you may have no choice but to go to a traditional labor and delivery room, where more technology is readily at hand. And the C-section (cesarean delivery ) is always performed in an all business operating room (no homey look there). Fortunately, though with the increasing availability of birthing rooms for most women, odds are great that you’ll be able to experience unrushed,  family-friendly, noninter-venionist  labor and delivery within a traditional hospital setting.

2.Birthing Centers. Birthing centers, usually freestanding facilities offer a homey, low-tech, and personalized place for childbirth.  You’ll be able to get all your prenatal care at a freestanding center – from practitioner visits to childbirth education and breastfeeding classes. In general, most birthing centers offer the most comfortable  childbirth  amenities-from nicely decorated private rooms with soft lighting  to showers and whirlpool tubes. A kitchen may also be  available  for family members to use.

Birthing centers are usually staffed by midwives, but many have on-call obstetricians; others  are located  just minutes from a hospital in case any emergencies arise. And though birthing  centers generally do not use interventions such as fetal monitoring, they do have medical equipment on hand, including IVs, oxygen for the mother and the infant, and infant resuscitators so emergency care can be initiated (if required)  while you’re waiting for a transfer to the nearby hospital.Still only women with low-risk pregnancies are good candidates for delivery centers.

Something else to consider : Unmedicated  childbirth is the focus in a birthing center, and though mild narcotic medications are available, epidural aren’t, if you end up wanting an epidural, you’ll have to be taken to the hospital.

3.Leboyer Births. Babies are often delivered in birthing rooms without the bright lights once deemed necessary, on the theory that gentle lighting can make the transition from the dark uterus to the bright outside world more gradual and less jolting. Upending  and slapping the newborn is no longer routine anywhere; less aggressive procedures are preferred for establishing breathing when it doesn’t start on its own. In some hospitals, the umbilical cord is not cut immediately; instead, this last physical bond between mother and baby remains intact while they get to know each other for the first time (and until it stop pulsing). And though the warm bath leboyer recommended for soothing the new arrival and smoothing the transition from a watery home to a dry one isn’t common, being put immediately into mommy’s arms is.

In spite of the growing acceptance of many leboyer theories, a full on leboyer birth-with soft music, soft light, and a warm bath for a baby – isn’t widely available. If you’re interested in one, though, ask about it when you are interviewing practitioners.

4.Home Birth. For some women, the idea of being hospitalized when they aren’t sick just isn’t the ticket. If that sounds like you – or if you just believe that life  should begin at home – you might want to consider a home birth. The upside is obvious: Your newborn arrives amid family and friends in a warm and loving atmosphere, and you’re able to labor and deliver in the comfort and privacy of your own home, without hospital protocols and personnel getting in the way. The downside is that if something unexpectedly goes wrong, the facilities for an emergency cesarean or resuscitation of the newborn will not be close at hand.

According to the american college of nurse-midwives, if you are considering a home birth, you should meet these guidelines:

. Be in the low-risk category – no hypertension, diabetes, or other chronic medical problems, and no history of a previous difficult labor and/or delivery.

.Be attended  by a physician or a CNM. If you’re using a CNM, a consulting physician should be available, preferably one who has seen you during pregnancy and who has worked with the nurse-midwife before.

. Have transportation available and live within 30 miles of a hospital, if the roads are good and traffic’s not  an issue, or 10 miles if these standards aren’t met.

5.Water Birth. The concept of delivering underwater to simulate the environment of the womb is not widely  used in the medical community, but it is more accepted among midwives. In a water birth, the baby is eased from the warm,  wet worm into another warm, wet environment, offering familiar comfort after the stresses of delivery. The baby is pulled out of the water and placed in the mother’s arms immediately after the birth. And since breathing doesn’t begin until the baby is exposed to the air, there is virtually no risk of drowning. Water  births can be done at home, in birthing centers, and in some hospitals. Many spouses join the mother in the tub or portable pool, often holding her from behind to provide support.

Most women with low-risk pregnancies can choose a water birth, as long as they can find a willing practitioner and hospital (birthing centers may be more likely to offer the option). If you’re in a high risk category, however, it’s probably not a wise option, and it’s unlikely you’ll find even a midwife  who will allow you to try a water  birth.

Most women find that the water not only provides relaxation, pain relief, and freedom from gravity’s pull, but even facilitates the progression of labor. Some hospitals and more birthing centers offer tubs in the   birthing rooms.


Conception, From Conception To Delivery
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