{End of Pregnancy} Birth Plan

Friday, October 23, 2015

Happy Friday friends! What are you up to today? We have a fun morning at the park planned, followed by a great Third Trimester Arm Burner (which I will post) and a run!
Oh, and there is the endless laundry that needs to be done.

Two weeks ago I wrote a post about Preparing for Birth. (You can find it here.)
I have had a few questions about making a birth plan, what each of the options I talked about meant, and why it was important to us. So, I decided to break down how we made our birth plan, into a series of posts to help other mama's out there prepare for their births as well.

The series will include:

Birth Plan: End of Pregnancy
Birth Plan: Labor
Birth Plan: Birth
Birth Plan: Postpartum

We don't have a written birth plan to hand to anyone when we get to the Birth Center. When it comes time for labor, your birth team is trained to take care of you and baby. They do so under the guidelines of their standards and their unique protocols, in addition to the protocols of the birth place. By having a care provider who shares the same standards and values as you, a written birth plan becomes unnecessary.

We did use a birth plan template to identify what is and isn't an important part of our birth experience, so that we could interview and find a care provider who is right for us. By finding that care provider who shares the same values and follows protocols that we are comfortable with, the type of birth we want is normal practice for them.

Birth is unpredictable. While the biology is the same, each labor and each birth are completely different. There are so many variations of how it can go and things that can come up. It's nearly impossible to discuss every variation of what could happen, ahead of time. This is another reason it is important to have a care provider you are on the same page with, and trust.

I want to start by saying that I don't believe there is any one right way to give birth. Birth is a personal experience for each family, and the most important thing is that the mother is given options, and makes the decisions that are right for her. What that looks like is different for every woman. This is what is right for us.

The first part of the birth plan we worked on was our End of Pregnancy Plan.

As you approach the end of pregnancy, some options will be presented at prenatal appointments. It was important to us to know where the care provider we chose, stood on these topics.

Internal Exams:  Towards the end of pregnancy, care providers often offer to check your cervix to see if you are dilated or effaced.
For my last pregnancy, I was in support of being checked. However, when they checked me at my 39 week appointment, I was not dilated or effaced at all. It was so disappointing. That was until less than 24 hours later when I was holding Aria.
I have also had birth clients who have been walking around 4cm dilated for weeks before going into labor.

Unfortunately internal exams at the end of pregnancy are not an accurate indication of when a woman will go into labor. If anything, it can just make you anxious.
Because I have seen so many variations of this, I'd prefer not to be checked this time.

Membrane Stripping: Membrane stripping is when your care provider inserts a finger into your cervix and separates the amniotic sac from the side of the uterus, near the cervix. This can jostle things around enough to help kickstart labor, only if your body is ready to go into labor. If it is not, then it'll likely just make you cramp a little and maybe cause some spotting. Your care provider may offer to do this for you around your due date.

For me, I didn't want a care provider where this was something they commonly did before or on the due date. I would like the option to try it if I go overdue. But, I didn't want it to be common practice before I even reach my due date (some CP's do that). Additionally, I wanted to be sure that they would obtain my permission prior to stripping my membranes (some CP's also do that).

Time limit to go overdue: Different care providers are comfortable with letting mom's go overdue different lengths of time. The max is generally 14 days. I wanted to be sure I would have the full 2 weeks to go into labor naturally, on my own.

Induction options: Should I go the full two weeks overdue, I wanted to know what options I would have for induction. With there being seven different ways to induce labor (yes, seven!), I wanted to know that pitocin would be at the bottom of the list.

Membranes rupturing prior to arriving at birth place: About 10 percent of women's waters break before labor starts. If you end up being one of the 10 percent, this can be a great question to know the answer to. Once your membranes rupture, many care providers have a time limit for how long you can be home waiting for labor to start, or laboring if it has started. If you are planning a low intervention birth, the time you are allowed to remain home, can be very important.

If you are group b strep positive, no matter where you give birth, you will be instructed to come in if your waters break, so that you can receive antibiotics. 

Options for breech presentation: Should our little girl be presenting breech, I wanted to know what options/suggestions would be offered to help her turn. Basically, it was important to me that my care providers be comfortable with trying everything possible, before considering a cesarean.

These are some of the most common options and topics that you will come across as you near the end of pregnancy. Research them, think about them, decide which are important to you for your birth experience and talk about them with your CP. A good care provider will respect the fact that you are doing your research and they will also want this to be the best experience for you.

Also, If you are looking for a pregnancy and birth book, The Birth Partner, by Penny Simkin, can be a great place to start. It's an informative, neutral, pregnancy and birth book, that doesn't sway one way or the other.

For example: Mom's who are looking for a medicated birth will find a breakdown of all of the different medication options there are, and different considerations for each. Mom's who are looking to have a medication free birth will find a ton of great support options, and suggestions for managing discomfort during a medication free labor. And if you aren't sure which way you are leaning, this book has laid out both paths for you, so you can make an informed decision.

It's a thorough guide to prepare for childbirth and all of the different options you will have leading up to your due date, during labor and birth and the postpartum period. It really covers everything. It's broken down into sections to make it easy to follow and locate anything specific you are looking for. I've found it to be very helpful for mom's as well as partners.

Be sure to check in next week when we talk about the Labor part of the birth plan! Have a great Friday!

What's in your End of Pregnancy Plan? 

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