CHOICES FOR CHILBIRTH
The two lists below
do not represent an "either-or" situation. Most parents choose their
options from both pathways. Very few doctors or midwives practice completely in
accordance with either pathway. Consider and discuss each option and then decide
which you prefer. Flexibility is necessary to ensure that the Birth Plan will
apply in difficult or complicated labors as well as normal and typical labors.
Induction
of labor.
Spontaneous
labor.
methods
: stripping membranes, amniotomy, gel, Pitocin, Sytotec.
alternatives
: making love, breast stimulation…
Limit
to one support people during labor and birth.
Presence
of other friends, relatives, siblings, doulas…
Enema,
shaving.
No
enema, no shaving.
Confinement
to bed and/or one position.
Freedom
to walk and change positions as desired.
(Hep
lock or permanent) IV fluids for hydration and energy.
No
Hep lock nor IV line. Drinking fluid or eating as desired…
Augmentation
of labor by Pitocin IV.
Natural
labor.
Frequent
vaginal exams.
Vaginal
exams when requested by mother or for medical reasons.
Electronic
Fetal Heart Monitor.
Listening
to fetal heart with fetal stethoscope.
Continuous
Electronic Fetal Monitoring.
Intermittent
Fetal Monitoring.
Pain
relief through medication: analgesics or anesthtics.
Relaxation,
emotional support, massage, breathing…
Lithotomy
position or semi-sitting in labor bed for pushing.
Choice
of position and freedom to move.
Prolonged
breath-holding and bearing down for expulsion.
Mother
follows her urge to push.
Routine
Pitocin as baby's shoulders come out.
No
routinely administration of drugs as baby comes out.
Limit
of 30 to 45 mn on 2nd stage, then forceps or cesarean birth.
Allow
for longer 2nd stage and position variations to help progress.
Delivery
table for birth.
Birth
in labor bed, birth chair, other places in the room, bath tub.
Lithotomy
position with stirrups for birth;
Sidelying,
all fours, squattinf, standing with leg up, semi-reclining with back support,
no stirrups.
Mother
not allowed to touch sterile field.
Mother
allowed to touch baby's head as it crowns.
Catheterization
in 2nd stage.
No
catheterization and frequent voiding in first stage.
Episiotomy.
No
episiotomy: massage, warm compresses, slower delivery, coaching to pant
out baby, support to perineum. Late episiotomy with no anesthetic.
Forceps
or vacuum extraction.
Spontaneous
delivery. Mother first to take her baby.
Cut
of the cord quickly after birth by practitionner
Allow
time for cord to stop puls. to be cut, poss by father,clamp bb only
Intubation/suctionning.
Waiting
to see if baby can handle own mucus.
Immediate
care of baby done out of sight of mother: id bracelet, Apgar, heat lamp,
bath with soap.
Care
done on mother's abdomen. Baby skin-to-skin with mother and blanket over
them. Mother-baby eye contact. No bath.
Limit
of 15-20 minutes on 3rd stage followed by manual extraction of the placenta.
Allow
for longer time (1 hour) for placenta. Allow mother to move around, nurse
baby, squat.
Pitocin
drip or injection for contraction of uterus after placenta is born.
Evaluation
of uterus before using uterine stimulant routinely. Breastfeeding.
Baby
to isolette or nursery for 4-24 hours. Mother to recovery for observation.
Baby
held by mother or father on delivery table and/or in recovery.
Eye
drops applied shortly after birth.
Omit
eye drops or delay administration up to 2 hours.
Baby's
first feeding - glucose water by nurse.
Colostrum
by mother who plans to breastfeed given by mother.
Baby
in nursery except for scheduled feedings.
Demand
feeding, baby to mother when crying, 24 hour rooming in.
Circumcision.
No
circumcision (orafter months/years).
Home
in 12 or more hours after delivery.
Early
discharge from hospital.
Common
Medical Procedures
Possible
Options
Scheduled
surgery.
Surgery
after labor begins.
Mother
without her support person in surgery.
Father
present to support mother.
General
anesthesia.
Spinal
or epidural.
Screen
to prevent viewing surgery.
Screen
lowered at time of birth or baby held up for mother and father to see and
touch.
Mother
not allowed to wear contacts or glasses;
Mother
to wear contacts or glasses.
Baby
sent to intensive care nursery.
Father
to hold baby and mother to see baby if baby is not in distress. Mother allowed
to breastfeed in recovery if her and her baby's condition permit. Mother-baby
Unit.
Adapted
to the French context from the penny press, 1980, (2005) by V. Lemaigre
Dubreuil
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