Wednesday, April 1, 2009

Planning Your Birth

Today, the evidence of risk of intervention in private vs. public is very sad. In public hospitals, the c-section rate is around 28% on average. In some private hospitals in Australia, the c-section rate is climbing part 60%. The World Health Organisation recommends a c-section rate of 10% to be a healthy number. (Here, a recent article in the Sydney Morning Herald delves more into statistics and reasons why the rates are getting so high.)
Below, I have written an article to help inform women of their choices, the difference between those choices and the importance of choosing your care provider carefully:
Where will you have your baby? Who will offer you support? Public or private? And the choices go on... Planning your birth is not just about having a birth plan, and here's why.

The choices you make during pregnancy will more than likely have a direct impact on what kind of birth experience you have, therefore largely determining how at ease you feel with caring for your baby after the birth.

Often the first major decision that needs to be made is where to give birth to your baby. Women can tend to feel rushed into determining where they will give birth and booking in (if a hospital / birth centre is chosen). But approach with caution, as you'll see that where you decide to have your baby and who supports you during this time could very well be the most important decision you will make regarding the birth of your baby. This is because the model of care that you choose in pregnancy can hold the consequence of limiting your options and choices during your labour and birth.

Consider your beliefs about birth. Does your chosen model of care uphold the same beliefs?
Consider what type of birth you desire. Is this type of birth encouraged or even possible with the model of care you have chosen? In other words, how likely is it that you will achieve this type of birth under this model of care?

Consider your definition of a safe birth for you and your baby. What are the statistics for the model of care you have chosen? Do you believe you can achieve your definition of a safe birth under the model of care you have chosen?

Consider who should be at the centre of your birth experience. Is the model of care you have chosen woman-centred, doctor-centred or perhaps protocol-centred?

Consider how much input you should have in your birth experience. Does your care provider practice active management (completing procedures before they are required, "just in case") or expectant management (wait and see how you and your baby handle it, then intervene only if medically necessary)?

Consider when you feel interventions may become necessary. Does your care provider practice any routine procedures or interventions? Do they practice evidence-based care (when there is evidence to prove that an intervention, under certain circumstances, is safer than not intervening at all)? How do you feel about interventions and are you comfortable with your care provider's policy on interventions?

As mentioned above, planning your birth is more than having a birth plan. But birth plans are probably the best way for you to inform your birth team about what you would definitely like to see happen, what you would definitely like to avoid and what you are open to. Make your birth plan easy to read and to the point. Include in your birth plan your decisions about support people, the environment, interventions, monitoring, who's catching your baby, who's cutting the cord, when to cut the cord and where you would like your baby straight after birth. Have your care provider keep a copy of your birth plan on file to check back on so that you only have to discuss a minimal amount whilst you are in labour.

Now that you have thought more about your model of care and your birth plan, the time has come for you to be conscious of the fact that your lifestyle during pregnancy can directly affect the experience you have during the birth of your baby. It is wise to make positive lifestyle choices during this time, including good nutrition, exercising well and getting enough rest. You might also benefit from preparing yourself physically for your baby's birth, practising positions you would like to use (e.g. squatting or lunging) .

Towards the end of your pregnancy, it is a good idea to be thinking about encouraging your baby to be lying in the easiest way possible to be born. Avoiding postures where you are slouching/lying on your back and making sure you spend some time each day in the "crawling position" will encourage your baby's spine to swing to the front of your tummy. This means your baby's face will be towards your spine, which is the optimal position for your baby to be born. You can find out more about this by researching "optimal fetal positioning".

Take the time during pregnancy to practise your relaxation techniques, including using breathing and meditation to relax your body and mind. These will come in handy later on; many women find that these techniques assist the most in helping them through the discomfort of labour.

Pregnancy is a time to inform yourself about your options and make choices that are right for you. Approach the birth of your baby with an open, positive mind and think of labour as being only one contraction at a time, with a beautiful prize and well-earned rest afterwards.

Remember, your body has been beautifully and wonderfully made and you CAN achieve the birth you desire!

I hope this has given you some "food for thought".
Jen Staniforth

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