Monday, October 20, 2008

Preparing For The Unexpected

Childbirth in general is unpredictable. The best way to prepare for a smooth labor and delivery is to take care of the mother through proper nutrition, exercise, prenatal care and education, and emotional support. Sometimes even after a smooth and uneventful pregnancy there can be unforeseen complications during labor and birth. It's primarily for this reason that I feel it's important for expectant parents to properly educate themselves prior to their baby's birth.

What happens when the bag of waters ruptures spontaneously and there are no detectable contractions or progress? What if labor draws on longer with little or no signs of progress and the baby is possibly at risk for infection? What if the baby is posterior (backwards) or breech (head-up position)? What can be done to turn a baby that's not in a favorable position for birth? What can be done to help augment labor naturally? What are the risks and benefits of augmenting labor artificially? What are the risks and benefits of pain medications like narcotics and epidurals? When is a c-section medically necessary? These are just some of the questions to be considered.

Women are generally given lots of information packets and forms at the first prenatal doctor or midwife visit, but how many actually read the information given? Even when a woman is admitted to the hospital for labor and birth she is given consent forms to sign. These forms have vital information about the possible medications and procedures that will be given and used during labor and their many side-effects, and by signing them a woman is saying that she has read and understood them. But how many actually read the long paperwork, particularly if the mother is already experiencing labor and focusing her attention on the contractions rather than the paperwork? When in the middle of labor the unexpected happens, does a woman know what her options are and is she prepared to make the best decision for herself and her baby? Is her partner prepared to make these important decisions for her if she's unable to make them herself? Sometimes there is the luxury of time to discuss options and make an informed decision in the middle of labor, but many times a decision needs to be made quickly for the sake of the mother and baby.

Whether you have a doctor or midwife; whether you plan to birth at home, in a birthing center, or in a hospital; whether you are planning a natural labor without medication or a fully medicated childbirth, you should prepare yourself for what's to come.

Plan for the best, but prepare for the worst. I certainly don't feel we should expect the worst, but prepare ourselves to be ready to make informed decisions when needed. With the last two of my baby's births I had a birth plan outlining how I wanted things to be done, as well as providing contingency options for possible changes to the plan. I knew beforehand what decisions I would make in various circumstances and felt fully prepared for what was to come. My doula and my husband were both instrumental in assuring that my plan was carried out by the hospital staff and doctor, and everyone worked together as a team. This is why I feel education and preparation is so vital in preparing for the birth of a child.

One metaphor I've heard is that when someone is making a big change or purchase they do research and explore their options before making the final decision. When one buys a new car they may visit several dealerships and look at different models, options and prices. They take their time finding the best deal for what they want and need. We should approach childbirth with as much interest in exploring options and making the best decision for ourselves and our family.

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