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Birth Plan Basics: FAQ about Elective Inductions of Labor

Q.  Should I have an elective induction of labor?

A. 

no3

 

 

 

 

Q.  I want to make sure that my OB is there for my delivery, should I schedule an elective induction?

A.

no1

 

Q.  My mother is flying in this Saturday, can I schedule an elective induction for Friday?

A.

no6

 

 

 

 

Q. It is my first baby and I am already dilated to 1cm.  I want to schedule an elective induction.

A.

      no2

 

 

 

Q.  I am 38 weeks and I am contracting 4 times an hour, I would like to schedule an elective induction.

A.

no5

 

 

 

 

Q. My ultrasound said that my baby was already 6 pounds at 37 weeks.  Should I have an elective induction at 39 weeks?

A.

no4

 

 

 

 

 

Q. I really want my baby to be born on 1/15/15.  Should I be induced electively?

A.

     no8

 

 

 

 

 

Q.  What about an elective primary cesarean section?

A.

no7

 

 

 

 

 

 

 

Q. If I have no medical reason to have an induction, should I let my baby choose his birthday?

A.

yes

 

 

 

 

 

 

I do not recommend an non-medically indicated elective induction of labor or cesarean section.

Inform yourself about the risks of inducing labor early.

Go the Full 40!

Association of Women’s Health, Obstetrics and Neonatal Nurses (AWHONN) 

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Birth Plan Basics: Chaperones During Sensitive Procedures

I have heard many women talk about their lack of modesty in labor.  The intensity of labor and birth often breaks down social and cultural norms of privacy and modesty.  It is acceptable to be less modest during birth if you feel comfortable.  You do not have to give up your modesty.  You can work with your care providers to ensure as much privacy and modesty as you need and want.

Another thing to consider is if you would like a chaperone during sensitive examinations such as cervical exams.  If your nurse or physician is male, a second care provider will commonly accompany him during the exam.  This does not always occur, but you can request a second person at any time.  You may request a chaperone no matter what the gender of your care provider.  Routinely female nurses will not seek out a chaperone. You will need to make your wishes known.  Women do not need to explain the reason they feel uncomfortable with only one provider at the exam.  Empowering women to request a chaperone is supported by the Association of Women’s Health, Obstetrics and Neonatal Nurses (AWHONN).  AWHONN’s position statement details who is an appropriate chaperone.   Factors that contribute to the decision to have a chaperone are also included.  It is up to you if your support people are present during these sensitive times.

My advice:  Read the position statement.  What are your preferences?  Discuss your feelings with your support person.  Include your preference in your birth plan.

Remember that you can change your mind and modify your birth plan at anytime.  If you did not plan on having a chaperone and during labor discover that you would like one, speak up!  If you planned on utilizing a chaperone and once you are in labor you decide that extra person is not needed, let your nurse know.  Some hospitals require a second provider to attend during sensitive exams.  If this is not acceptable to you then accommodations can be made.  For example, ask for the second person to stand behind the curtain.  Communication with your physician and nurse will be key to your experience.  Speak up, ask questions and let your preferences be known.

 

 

Happy birthing!
sleeping

 

 

Digiprove sealCopyright secured by Digiprove © 2015 Carrie Halsey
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Birth Plan Basics: What Should I Wear in the Hospital?

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I am frequently asked about the patient gowns that women are given to wear in labor.  Mothers want to know if they should and/or have to use them.

Comfort is important.

Many moms worry more about how their feet will look or shaving their legs before labor begins than what they will wear in labor.  It is good to feel comfortable in labor.  If getting a pedicure before delivery puts a mother at ease, then she should get one! The clothes a laboring woman is wears during the hours of labor and birth may have a bigger impact on her comfort than the color of her toenails.

What are you allowed to wear in the hospital?

You do have a choice!  I have labored mothers in everything from being absolutely naked. to being covered hear to toe. You are not required to wear a hospital gown.  You can wear whatever makes you feel comfortable.  There are some restrictions in the operating room.  If you are having a scheduled cesarean section or end up there after laboring, you will need to wear the hospital gown.  Hospital gowns are preferred in these situations due to infection risks and the types of monitoring equipment used in the surgery.  If you still would like to wear something else to surgery discuss your options with your nurse or doctor.

Pros and Cons of the hospital gown

Pros:

There is a fresh one waiting whenever needed.

You don’t have to worry about getting blood, poop or vomit out of it later.

Some are designed for breastfeeding or monitoring ease.

Cons:

They are made to accommodate a large variety of sizes and usually do not fit well.

Modesty can be an issue, especially while walking in the halls.

Hospital gowns can make you feel like a sick patient and less empowered.

What are my clothing options?

Occasionally I have labored a mother whom was only comfortable completely naked.  These were all patients that were laboring unmedicated. I provided modesty when she requested it with sheets. Tank tops or breastfeeding tanks are popular.  Sweat pants, shorts or yoga pants are easy to slip off for cervical checks and are comfortable for labor.  Skirts are comfortable, modest and do not need to be taken off for pushing.  There are specialty lines for labor clothes for example: http://www.prettypushers.comThe specialty clothing is designed to accommodate monitoring equipment and maximize utility and comfort.  If you do not want to pay the specialty price, there are plenty of other options.  In my most comfortable delivery I wore a breastfeeding tank and a maxi skirt with a wide, elastic waist band.  The ultrasound and toco monitors fit in the band so that I did not need to wear the monitor belts.  I moved around very comfortably and always felt modest.  When it was time to push it was easy to pull the skirt up and out of the way of the delivery.  I did not plan on wearing the skirt again, but I was happy to find that the evidence of delivery washed out easily.  I wore that skirt multiple times in my postpartum months.

Postpartum Tips

If you choose to wear the hospital gown for labor and delivery you can still wear your own clothes after delivery.  It is good idea to bring 2-3 pairs of comfortable, stretchy clothes with you for your postpartum stay and the drive home.  The hospital’s maternity underwear are disposable and great for giant pads.  Some moms prefer to bring in their own underwear or brief type panties.  Hospitals will often provide slip resistant socks for their patients.  You can bring in your own socks or slippers if you wish.  Breastfeeding moms will spend a lot of time with the baby skin to skin during the first few days.  Nursing bras are not vital for the hospital unless you feel uncomfortable without a bra.  You may want to wait to buy nursing bras until after your first week at home since your bra size will likely change.

 

The bottom line.  

Its your bottom and you can cover it however you wish!

 toilet

 

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Birth Plan Basics: Using BRAIN

image“Well, you are the expert; we will just do what you tell us.” Admittedly it is nice to be regarded as an expert, but these are dangerous words. There is something about wearing a white coat and a stethoscope that grants healthcare professionals great power over their patients. Intelligent women and men come to the hospital and abdicate their decision making power at the door.

Your perinatal team has varied knowledge, training, experience, bias, fear, and motivation. They are experts, but they are not perfect! They have seen a lot, but they haven’t seen everything. Some have not read a new research article in years, some haven’t slept in 2 days, and some had a maternal death patient with similar risk factors as yours. Sometimes they just want to go home on time and your labor is taking too long. Some of them are biased towards low intervention, others have never met a patient they didn’t want to take to the operating room.

When you are admitted to the hospital you will not know what is behind the smiling faces and monitoring machines. In most cases what you see is what you get. Doctors and nurses that are working hard to make ensure you and your baby make it safely through labor and delivery. There are many paths to that outcome. You need to be a part of the decision making.

The first step is to get educated prior to the delivery. Taking a prenatal class is an excellent way to prepare for childbirth. I personally recommend the Hypnobabies course, but there are many other programs available. Check with your local hospitals. They often offer low/no cost courses and you will be able to learn more about how labor is approached where you will be delivering. If you do not have time to attend a traditional class, there are self study options or online courses available. AWHONN, INJOY, and Evidence Based Birth are websites that have great information.

The second step is to make a birth plan. If a written birth plan is not appealing, you can still take time to discuss with your support person and your doctor/midwife your thoughts, goals and wishes for your labor and delivery. Having a mutual understanding can help make decisions during labor easier.

Third: Use your BRAIN! Every decision you make should be collaborative between you and your healthcare team. The most important person in the equation is you. Each time a decision is required, use the simple decision making tool BRAIN.

Benefits: What are the benefits of the intervention?brain

Risks: What are the risks involved? It is important to explore this and get the full list of risks. Many times healthcare providers will mention the most common or the most devastating risks. You need to be told all the risks to be able to make an informed decision.

Alternatives: Are there alternatives? Sometimes there are no alternatives, but in many situations there are alternative interventions that can be attempted. Find out your options and if you have an alternative in mind, suggest it.

Intuition: Take a minute to think and discuss with your support person. What is your gut telling you? Doctors and nurses use intuition to care for their patients too.

Nothing/not now: What if you did nothing? What if you waited an hour or three? Time can clarify most situations. In other situations doing nothing may cause a bad outcome for you or baby. How does doing nothing affect this particular situation?

Being empowered and educated will help you have the birth experience that is best for you and your baby.

Remember to use your BRAIN!