The good news is that you already took the first step in creating your birth plan when you selected your healthcare provider. Most practices will introduce you to their birth care philosophy when they take you on as a patient or client. With this in mind, you can work together with your health care team to create a comprehensive birth plan that will keep everyone on the same page during your delivery. Labour is generally thought of as happening in several phases: early labour, active labour, transition, and pushing. If you’re being induced, you will also want to consider the care you want to receive before labour starts, as well as during and after delivery. Induction
Talk to your doctor or midwife about their policies and procedures around induction. Being induced can decrease your chance of having a ‘drug-free’ birth because it requires monitoring that can inhibit your ability to move around and alleviate pain. Also, the use of Pitocin, the drug that brings on contractions, is correlated with a significant increase in c-sections. That being said, if you or your baby are at risk for a number of different conditions like gestational diabetes, hypertension, preeclampsia, or HELLP syndrome, your health and safety may require delivering early. Your doctor or midwife should be able to answer any questions you may have and help you understand the risks and benefits of induction. It’s a good idea to write down questions when you think of them, so you can bring them up at your next appointment.
Hollywood makes labour seem like a huge rush from the first contraction to the urge to push, but in reality, early labour can take many hours (or even a few days!). Many people worry that their water will break out of the blue (like, while out in public), but actually, this only happens in about 10 percent of cases. Usually, you’ll feel some irregular contractions first, then these will intensify and regulate to signal the start of labour. Your water may break at some point, or your healthcare provider may offer to rupture your membranes later, in the hospital. Early labour lasts until you are about three to four centimetres dilated.
Now is the time to ask yourself:
● Where would you be most comfortable spending this time?
● Who would you want around you?
● What measures would you like to use for pain management?
Active labour is marked as the time it takes for your cervix to dilate from four to seven centimetres. Contractions increase in both duration and intensity. This is likely the time you would be leaving to go to the hospital or birthing centre (unless you’ve been advised to come in earlier).
You may also want to consider the following:
● What will you feel comfortable wearing?
● Do you want to use aromatherapy?
● What type of music would you like? (Dance that baby out!)
● Who will be your support team?
● Do you want to be able to move around during labour or rest as much as possible?
Transition is the final stage of active labour when a woman progresses from seven to 10 centimetres. It’s often very intense, but it tends to go quickly. If you are planning an unmedicated birth, this is likely the point at which you might reconsider that decision, so here are a few things to think about:
● Do you want to be offered pain medication? Do you want someone to help you say no if you’re offered pain medication?
● Who would be the best birth coach for you during this time?
● At what point or under what circumstances would you want your healthcare provider to perform a c-section?
● Is there anyone you would prefer not to be in the room with you at this time?
Congratulations! You are about to meet your little one. This is a truly exciting time, but still one with decisions to be made:
● Discuss with your doctor or midwife under what circumstances you would need or be offered an episiotomy
● Do you want someone to hold a mirror so you can watch your baby be born?
● Do you want to help pull your baby out, if possible?
● Do you want your partner or support person to watch the baby be born?
● Do you want someone to take photos or videotape? Is this allowed by your care team?
● Who would you like to announce the gender?
After birthing your baby, you are likely to be feeling a huge surge of emotions. Make sure your wishes are known beforehand to ensure a happy memory.
● Who is cutting the cord? Will you be doing cord blood banking?
● Can the baby be placed skin-to-skin immediately? If so, for how long?
● Will you be breast- or bottle-feeding?
● Who will be the next person to hold your baby?
Every pregnancy and baby is unique. Your baby’s measurements and milestones may vary from the information provided. Always refer to the advice of your healthcare professional.