Did you know that the average couple spends more time researching what car to lease or what house to buy than they do preparing for the birth of their child? Don’t be a statistic! Learn about your options so that you can make the best decisions possible regarding your pregnancy, birth and the start of your baby’s life. In doing so, you can use these options and the ones that are important to you, to create a birth plan to share with your care provider and your doula to make sure you all are on the same page (and if you’re not, it’s time to think about finding someone who is). Here are some choices you have that you may have never thought about or known were choices before…

Pregnancy

Care provider

Midwife, nurse-midwife or doctor?

Setting of prenatal visits

In your own home, or at an office or birth center?
Can the time/day be when it is convenient for you and your partner or do you have to change your schedule to fit your provider’s?

Length of prenatal visits

How much time would you like to be able to spend with your care provider? 5 minutes, 30 minutes or as long as you need?

Laboratory testing (blood and urine)

Are you giving your consent and is your provider explaining what each test is for? Are you being given your options or just being told that you need to do something?

Ultrasounds

Are you having ultrasounds recommended to you only when they are necessary or at each visit to measure “size of baby”? (Side note: ultrasounds in the 3rd trimester can be off by up to 1-2 pounds when it comes to measuring the size of your baby, so don't let this be the only reason why someone suggests an induction)

Vaginal exams

Rarely are they medically necessary prenatally, so are you requesting one or is your care provider pushing for one?
Is your care provider explaining their reasoning and asking your permission rather than just telling you to strip?

Induction

Is your provider discussing induction when it is not medically indicated (ex: big baby, holiday/dinner/golf time approaching, etc)?
How long will your provider "let" you go past your due date before wanting to induce?

Connection with your birth team

Do you feel everyone who will be at your birth is there for YOU and with YOUR best interests at heart?
Do you have a relationship with your provider that makes you comfortable and excited to see them at each prenatal and at the upcoming birth?

Birth

Location of birth

Home, birth center or hospital….hopefully not in a car!

Who you would like present for your birth

See my other blog posting about who to invite to your birth

Clothing

Your own clothing vs. an issued gown

Do you want a routine IV placed in your arm to provide fluids?

Eating and drinking

Did you know that most hospitals don’t allow moms to eat or drink in labor?! Who would have thought that was a “choice”? (And no, IV fluids are not the same thing when it comes to caloric intake and providing energy in labor, so don't let anyone fool you otherwise)

Having your water broken ("artificial rupture of membranes")

Ask about the benefits vs. the risks, and make the decision that’s right for you. Don't be afraid to ask for privacy to talk to your partner alone when making a decision.

Freedom to move however you’d like in labor

Would you like to lie down, walk around, be hands and knees, squat, etc?

Intermittent fetal monitoring, instead of continuous monitoring

This is very important if you want to be able to move around and have a better chance at an unmedicated or low-intervention labor and birth. (Side note: for moms who are higher risk, this might not be an option for you due to safety concerns for baby)

Epidural

While there are benefits to epidurals and they can be helpful tools in labor, they also carry risks and can create a spiral effect of interventions for your birth (ex: urinary catheter, continuous monitoring, episiotomy, vacuum extraction, c-section, etc). Be aware of the benefits and risks so that regardless of the outcome, you’re happy with your decision.

Birthing position

Shockingly enough, babies can be born without moms on their backs and their feet in the air! (Though you'll be hard pressed to find a doctor who will agree to any other position)

Water birth

Are you wanting to labor or birth in the water?

Placenta

Would you like to be able to see your placenta?
Are you wanting to take it home to plant or encapsulate?

Baby

Delayed cord clamping

At time of birth, 30-40% of your baby’s total blood volume is still in the cord and placenta, so if your provider clamps the cord right away, your baby will be starting life on only 60-70% of the blood they should have had. (And this is important for all babies, not just premature ones!)

Skin-to-skin

Do you want to have skin-to-skin with your baby for a minute, 5 minutes, or over an hour? All initial newborn exams and evaluations (ex: APGAR score) can be done with baby on your chest, so unless you think your baby might grow several inches in the first little bit of life, probably okay to delay measuring and weighing baby to give you time to bond.

Breastfeeding

If you want to breastfeed, make sure no one will be giving your baby a bottle of formula/sugar water, or a pacifier

Vitamin K

Do you want your baby to receive injectable, oral or no vitamin K treatment? Definitely do your research as there are benefits and risks for all 3 options.

Erythromycin eye ointment

Does your baby need it? (ex: you currently have Chlamydia or Gonorrhea, or could possibly have contracted from your partner it without your knowledge)
Can it be delayed so that baby’s sight isn’t impaired during that crucial first hour of bonding?

Hepatitis B vaccine

Does your baby need it? (ex: you’re going to be getting your child tattooed or allowing them to swap fluids with someone who has Hep B, you probably want to get it ;-) )
Can it be delayed or does it have to be given within a day or two of birth?

Rooming-in

This is when baby stays with you the entire time instead of being taken into another room or to a nursery.

Circumcision

Research both sides of the argument and inform yourself before making a decision either way. I always recommend my clients read articles that are both pro- and anti-circumcision to see which resonates with them, as well as watching a video on how the procedure is done so you can be prepared if you choose to do it. This is a very big decision for your son and you don’t want to make lightly.
If you choose to circumcise, can it be delayed until baby is a week old so that there are fewer risks involved? (ex: hemorrhage, breast aversion, etc)

Bathing your baby

Do you want your baby bathed soon after birth? At 6 hours, 1 day, 2 days, or 1 week? There are benefits to allowing the vernix time to soak into your baby's skin, rather than being washed off. Also, soaps can be very drying to sensitive skin.
Who would you like to bathe your baby? (ex: care provider, nurse, father of the baby, you, etc) Keep in mind, who do you think will bathe your baby more gently?

There is so much to learn about pregnancy and birth, and I understand it can be very overwhelming for parents to have to consider everything and make so many decisions. You may think ignorance is bliss, and want to leave all the decisions up to your care provider to decide what is best for you, but don't do it! If you don’t know where to look to find information, or want to learn more about something, reach out! Contact someone who does know about these things and have them point you in the right direction. You can contact your care provider, child birth educator, doula, La Leche League member, or even me! Regardless, whether you make the decision or you let someone else do it for you, that is still you making a decision....make sure it’s the right one for you.