Thinking about your birth plan
Naturally, all mums-to-be are curious about childbirth. Read as widely as you can from early on in the pregnancy and discuss the birth with your partner, midwife or birthing partner before formulating a ‘birth plan’ or description of how you would like the birth of your baby to progress.
Of course, given the many contingent factors, the birth may not happen at all ‘according to plan’. Relax; the time spent exploring and planning the birth will help you know your options, as you’ll need to be flexible.
First stage of a natural
A natural birth (where you are not booked in to your hospital for an induction or caesarean section) will begin with contractions of the uterus. There may be some preparatory contractions which start and stop for days or even weeks before the birth – these are called Braxton Hicks contractions – but in first stage contractions will be sustained and regular over a period. How long this period will last and how quickly your contractions will build up to active labour will depend on the individual; research suggests that everything from your level of fitness, to whether this is your first natural childbirth, to how worried you are about the birth impact upon this.
During the first stage you are likely to be at home, or not confined (by IVs or foetal monitoring devices) to your room in hospital. Walking, gentle squats on a birthing ball or moving in a water bath are recommended for this stage as movement stimulates the uterus. Attending antenatal classes in the weeks before the birth will allow you to practise movements which loosen your pelvis and help the baby into a good position for birth. Classes will also help you think about what position you would like to be in when you deliver the baby, whether you are happy lying in bed, or would prefer to be squatting or standing supported by your partner or birth partner.
Pain relief options during the middle to end of the first stage will depend on whether you are at home or in hospital. At home, your midwife will advise you on natural pain relief to compliment your body’s own pain threshold. Tens machines, massage, hypnosis and water baths may all be options you can discuss with your midwife and birthing partner. In hospital, you may be able to choose medical pain relief, such as an epidural, nitric oxide (gas & air) or other forms of pain relief such as Pethidine.
Your birth plan should detail how you feel about pain relief, movement, delivery position and birthing partners. It should also indicate what sort of mood you would like to create in the room; would you like the lights dimmed, prefer silence or like a particular type of music to help you through?
Second stage of a natural birth
Once your pelvis has widened or fully dilated, powerful contractions begin to propel the baby down the birth canal. You may feel the need to ‘bear down’ at this stage or you may be prompted to do so by your midwife. The length of this stage is also dependent on many factors; what kind of pain relief you have had, your levels of exhaustion, worry, and the position of the baby.
With this in mind, it’s important to make some decisions about the actual birth of baby, and the delivery of the placenta beforehand. If you have your partner present, for example, would they like to help the baby out or cut the umbilical cord? If you need a caesarean section, would you like to hold your baby before he or she has been cleaned or the cord cut? Would you like to breastfeed your baby immediately?
Your partner and birth partner
Some husbands or partners feel confident to act on behalf of their labouring partner, others may prefer to defer to a midwife, birthing partner (your mum, sister or friend) or a doula. Some first time mums and dads prefer to use a doula on their first childbirth, not only for emotional and physical support, but also because doulas know what to expect and can act as an experienced advocate for how you would like your birth to progress.
Discuss both options with the people who will be caring for you during birth, so that you can make a plan which works for everyone.
Expect the unexpected
Your birth plan will also help you explore unexpected turns in your labour, such as premature babies (who come earlier than expected), breech babies (who are positioned feet or bottom first instead of head first), labour complications which may result in a caesarean (or c) section), or overdue babies. Anticipating and writing down how you would prefer these situations to be handled allows you time to investigate the options.