Making Your Birth Plan

once you finally decide which dresser makes the cut. Well, what about your plans for birth plan? Maybe you already know exactly how you'd like your labor and delivery to go, down down to your music playlist and your preferred guest list. Maybe you're said, on some specifics, there's definitely an badureau with your name on it, but you're questioning others. Do I hire a doula, consider cord blood banking? What is

cord blood banking? Maybe you're wondering whether there's another C section in your future, or whether you can and should give labor and vaginal birth a try this time. Or maybe you don't have a clue about where to start when it comes to your birthing options, or even which options will be open to you or won't be, depending on where you're giving birth and who's delivering your baby, as well as whether you'll be bringing any risk factors

to your delivery. No matter where you stand on giving birth and whether you'd rather take it lying down or sitting down or on all fours, we've got you today. We're deep diving into all the different birthing options so you can pick and choose what's right for you, keeping in mind that even the best laid birth plan is just a plan, and that mother nature and your baby may have other plans. After all, you can never be exactly sure what to expect during labor and delivery, except

for that beautiful baby of yours. I'm here with Emma. Hey, mom, Well I was at your birth, but you know, I honestly don't remember if you had birth plan, did you? Actually? I had a birth plan for both labor deliveries. My only birth plan was epidural. That was my only given. You wrote one word down on a piece of paper, one word down, and I was like done to doctors. I mean, besides the epidural, I did cord blood binking. I wanted delayed clamping, and you were a big part

of that. I was like, I need her in the room, So epidural, cord blood delayed clamping. You. I guess baby daddy. I guess baby Daddy. And my first pregnancy, I wanted to have an extra stitch in my afterwards. So that was actually in your plan. In my head plan, I didn't write a baby book. I didn't do any of it. So honestly, like my birth plan could have been like a post it maybe somewhere around the house, but that would have done you a lot of good. Yeah, I

went broke. I really didn't have a birth plan, I guess per se. Okay, so you just made all of that up. No, but my my epidural was my number one birth plan. I do recall that. So everything went according to plan in that you had an epidotal both times. You know what, my goal lift was very low, so of course I met it. I met my my goal. I reached my birthing bar. My birthing bar was low. No pun intended, isn't they were like really a birthing bar, Yes,

there is, but not if you have an epidural. But going back to when I delivered you, we didn't have a birth plan. We showed up at the hospital and we were lucky to get the one birthing room because back then they were just starting to designed birthing rooms, and so there was one in the entire hospital, and we scored it. So we were super excited about that. That was probably the only thing I was super excited about because I did not I did not have an epidural.

I would be too, That's like, that's like gold. It was progress. It wasn't where we are now with hospitals. But yeah, after the pendulum swung from when my mom gave birth and everybody was under general anesthesia and then the pendulum swung back to all natural all the time, so I wasn't given the option of an epidural. I went in there attempting to breathe, but I couldn't remember any of the breathing exercises that we learned in class, so I just whimpered quietly into the pillow. That's here.

But what trends have you noticed in terms of birthing options. A lot of my friends actually have had natural births and they cannot relate to my epidural story. One of my girlfriends was like singing while she pushed out her baby naturally. It was like, this a beautiful experience. My other girlfriend has had two natural births and then she couldn't have any more babies herself, so she had a surrogate. That's a trend. Dula's are a huge thing right now. I didn't have a dula. I kind of regret that

you were maddula. Yes, but I think no matter how you go in there, I think it's a beautiful experience giving your giving life. So even if you end up have any C section, or you circcumb to the pressures and have an epidural like me, or you give birth naturally singing, I mean, it doesn't matter. As long as it gets done, it's still going to be a beautiful experience when we come back. I am answering the biggest

questions you have about birth options and making a birth plan. Okay, mom, let's break down the biggest questions our listeners have when it comes to making birth choices. First things first, why make a birth plan in the first place. Well, listen, you definitely don't have to have a birth plan to give birth, and plenty of parents don't have one, and

of course they still give birth. That said, even if you don't end up with an official document or even a post it, like you, it's a good idea to explore all your birthing options and have at least a general idea of how you'd like things to go in your best of all possible birth scenarios, and then you can talk over you know, what's essentially a wish list with your O B or your midwife and kind of use it as a springboard for conversation and discuss what's

probably possible, what's possibly possible, what is impossible at all, based on hospital protocol and dr policy. So, for stance, if you're walking in expecting to have your delivery videotaped because that was in your birth plan, that can lead to disappointment if you walk in and you find out that the hospital of the doctor doesn't allow video. And you know, the same thing if you expect a birthing ball to be provided but then you find out it's a b y o B. You know, bring your own

ball kind of hospital. So again it's used the plan as a springboard for conversation ahead of time. But definitely not as a spring it on your doctor urmand wife at the last minute kind of conversation at deliver. That's totally what I would have done. Where's my ball, right? Okay? I have some friends who gave birth at home bravo, and everything went well. I never considered any place by the hospital and what about birthing centers. So there has

been an increased interest in home birth. It's kind of a backlash against that surge and c sections that we've had, many of them are preventable, and what some like to call the over medicalization of birth. And you know, I get it. I get it. Hospitals are considered places where people go when they're sick, they go for treatment, their places with all kinds of regulations and all kinds of policies.

Although the labor and delivery department is by far the happiest place in any hospital and it's certainly my happy place, especially in the time of COVID, that concern has been driving some moms away from hospital births and into home births, and particularly with more restrictions in hospitals due to COVID concerns like limits on who can be with a mom when she's in labor and delivery. For those who favor home birth, the biggest benefit is obvious. Home is where

the heart is. It's cozy, it's familiar, it's comforting. You get to decide who's with you at the birth, you get to set the policies, and as long as everything goes according to plan, you get to do it your way. Start to finish labor in a tub, person a tub, eat and drink what you want, move around anywhere you want to, and welcome your baby into your arms at home.

And that's a beautiful moment. And that's usually how it goes down in a planned home birth, especially if your pregnancy fits neatly into the low risk category, so no high blood pressure, no previous c section, babies not pre term or breach. But you know, even even a low risk birth doesn't always go according to plan, and complications can come up that suddenly require medical intervention, like an emergency c section, and that can put a baby and a mom who are at home and not in a

hospital setting at risk. And it's because of those risks that ACOG. You know, American College of obichi Lands really does recommend very strongly against home birth and even during a pandemic, actually especially during a pandemic, since hospitals can take more of those safety precautions to protect you and your baby than you could take it home, and they

do so. If you are even thinking about a home birth, first make sure that you fit that low risk profile, and also that you can find a certified nurse midwife who does home birth and is backed up by a consulting physician. And that alone isn't so easy because certified nurse midwise most of them do all of their deliveries

in hospitals. Actually, you also need to make sure that transportation is going to be available in case you need a very fast ride to a hospital that's hopefully very very nearby, and especially during a pandemic when emergency response is stretched so thin, and maybe when you don't necessarily want to roll up to the hospital at the emergency department entrance instead of the labor and delivery department. Now

a good compromise our accredited birth centers. If your low risk, you prefer to play it safer, since you'll get the low tech birth, you know, a more relaxed and comfortable environment than a hospital provides. You'll be delivered by a midwife in a tub if you want to, because hospitals, for the most part don't do some will, but most

don't do water births. Although you can often labor in a tub in a hospital, what you're not going to get is an epidural if you end up wanting one or you end up needing one, and you'll still need to be transported if there was an emergency. But also you've got to remember that, depending on what's on your birth plan, you might be able to get everything you want, or at least most of what you're looking for in a hospital birth also, and that's especially true if you

choose a midwife to deliver your baby. Plus you'll have the security of knowing that you've got your medical basis covered and your baby's medical basis covered just in case. Okay, but what exactly should a birth plan include? Well, it depends on you. If you're only going to have enough things to fit on a post it, well then that me. That me. But they can be encyclopedic and people take them very very seriously, and they should if that's what

they want absolutely everything spelled out in micro detail. They can also be super laid back, just a few key bullet points, but you need to put in what's important to you or what feels important to you now, understanding

that things could change. So having a duela and your partner there plus other guests if they're allowed, being able to eat if you're hungry, going unmedicated, or signing up for the epidural, having a berthing bar or a berthing stool or a chair, using warm compresses and paraneal massage to help facilitate labor and delivery, and avoiding an episiotomy or a catheter or an ivy delayed chord clamping, chord blick election, having dad cut the cord, or even catching

the baby. Now, the option of trying for v back, which is a vaginal birth after cesarean instead of opting for a scheduled repeat c section is something that's more available than ever, and lots of moms are having successful feedbacks or having a gentle c section. That's something that's new or newer. So for instance, the lights might be lower, soft music, a clear drape, and any monitors and equipment.

It's going to be strategically placed on one side so that you'll be able to do skinned skin immediately after the baby arrives and even breastfeed right away as long as there's no emergency. And of course you can also add any special requests about the placenta, like seeing it or saving it. Okay for what, some moms end up popping it, so they haven't made into popping it as in a capsule. They have made into drops or into capsules, and that's called placental encapsulation. Yes, a lot of people

I know have done that. People swear by it. So those who do it, they say that it improves your postpartum mood, and it boost your energy, and it helps with milks supply. And there's no scientific evidence that it does any of those though that definitely could be a placebo effect, but there is some concern about bacterial contamination. So it's a conversation to have with your provider ahead of time, you know, food for thought. And yes, some moms do eat it or bring it home to barry.

I have actually seen that done a lot in Africa. In fact, in one African village we were in, moms weren't coming to the clinic and the clinic realized it was because they were afraid the placenta would be taken away from them so they wouldn't be able to bury it. Fun fact, after I gave birth to Sebastian, Lennox came in the room and he was like amazed by my placenta that was just sitting in a bucket and my o b let him put on gloves and touch it.

It's an incredible organ. Okay, So one day you think moms need to be more flexible with their birth plan. Always you can engrave it in stone or even in sharpie. You know, flexibility is the most important feature of a good birth plan. And not just the flexibility that you need to twist yourself into those preferred pushing positions, but flexibility in your plan because remember, chances are good that

everything's going to go according to plan. You know, if your plan is realistic and it was approved by your provider, but you cannot predict how your labor is going to progress or not progress, and whether you'll end up needing a procedure that you were hoping to void or you end up wanting one. Like let's say you were dead set against having an epidural and then somewhere around six centimeters you become dead set. I haven't one that can happen too. Yes, I know a lot of people that

has happened too, and that's okay. It's not a bad thing. No, of course it's not. Of course, you can change your birth plan in the middle and you're still going to give birth, so exactly, and that's why flexibility is so key. Okay, So what about cord blood clamping, banking collection? What do we need to know about this? Because this is something that I did with both of my pregnancies, and I'm really glad I did, but I do remember doing delayed clamping.

Is that part of it? Yes, you can actually do the delayed clamping plus the cord blood collection, so plamping is given. I mean, you're you're not going to bring your baby home with the cord in the placenta attached. So for the record, that is a thing, and it's called a lotus birth. You leave the cord and pla sent to attached to the baby until it falls off naturally, and it's really not medically recommended at all, so it's probably something you should not add to your birth plan.

But delayed chord clamping for a few minutes to allow for a baby to soak up the most benefits possible from that blood rich chord before it's cut. Is something you should talk to your doctor or midwife about ahead of time. It's recommended by w h O, and it's done routinely and a lot of hospitals and by a lot of doctors in midwives. But absolutely talk this over ahead of time and specify what your wishes are about delaying cord blood clamping. Now ask for cord blood collection

and banking. That is something you definitely cannot walk. I guess I should say wattle into the labor and delivery for and request at the last minute. You're gonna need to plan ahead, even if you don't have an official birth plan. So first of all, you might be wondering what exactly is in cord blood that makes it special enough to save, And in fact, there's a lot in that cord blood. It's packed with stem cells. These include cells with the incredible capacity to be turned into any

other kind of blood and imane cell. So cord blood cells and you can also collect and store placental blood and tissue, which contain even more stem cells. Is already being used in the treatment of blood diseases like leukemia and sickle cell anemia. As well as some immune cell disorders, but there's way more potential in those cells, and researchers are looking into them as treatment for autism, cerebral policy,

and many many other conditions. Right now, there are two kinds of banking, private which you have collected and stored at your own expense, but you have access to if your baby or someone else in your family ends up needing it, and public, which you don't pay for and you don't control. So once it's collected, it goes to a public bank, just like blood does for used by

whoever ends up needing it. It's important to have this conversation with your doctor midwife really earlier because you're going to have to have all your core blood duties in a row by thirty four weeks the latest, and that includes signing up. My take on this, the A p S take on this, and a cogs cord. Blood is a terrible thing to waste, so instead of tossing it, which happens in the case of most chords, consider banking it.

If costs is not an object, you can pank it privately, so you can think of it as insurance you're probably never gonna end up tapping into it, but it's there just in case. If costs is a concern and it is a pricey proposition, especially because you have yearly storage fees stacked on, definitely go for the public option. I mean someone, maybe even your own little one one day, might benefit from those cells, and the medical waste been definitely will not benefit from them. Also, siblings to write,

potentially siblings. It's really an amazing thing. I'm really glad I did it. I'm really a fan of the public option just because you know, then it's accessible to everyone, and hopefully that would mean that more families would do it and we'd have more colored blood to to tap from. What childbirth classes should parents to be looking too? I mean, we didn't do it because I knew I want an epidural on that ship. Okay, so number one, you did, and every mom and dad should take a baby CPR class.

That's super important no matter what you decided to do in childbirth. But you know, I always suggest taking childbirth education classes even if you're pretty positive that you have zero interest in breathing your way through labor and delivery. And that's because a good class is going to teach you plenty more than natural childbirth techniques no matter how you end up delivering, including by C section or with

an epidural. And plus, if the classes are offered through your hospital or your provider, then they're going to give you a much more accurate idea of what you're going to expect at your delivery. And there are tons of you know, different techniques to choose from. There's Lamas, there's Bradley. You can take any of them online or on zoom. But I actually happened. I never have done it myself,

but I've heard such amazing things from moms. I'm a huge fan of hypno berthing, which it sounds very Vegas, but it's not like, you know, you go into a trance and bark like a dog or something, and yeah, it's just that you learn how to put yourself into a deep state of relaxation and itself hypnosis so that you can, at least to some extent, block out the pain. And for some moms it's incredibly effective. They can block out all the pain. For some it's just getting super relaxed.

And it really it's something you can learn in class and then put to good use much later on when you have a newborn and you really need to find your your mom home when the baby's crying and you're on your third diaper blowout of the morning and the washing machine is on the blank You know that kind of day. We all have them. Okay, so Simon cuts Sebby's cord, but he didn't catch him. Is that something that dad's really do? They seem so slippery and gooey.

Dad's cannon often do cut the cord, keeping in mind that a in case he's worried it doesn't hurt the mom or the baby to cut the cord. And be cords are way tougher to cut through than you'd think. And see if there's a complication, you know, he might get cut out of the deal entirely. But as far as dad actually catching the baby as the baby is born, it's done more at home birthts than in hospitals. But when it's done in a hospital it's called the three

handed catch. It's more of a symbolic catch. So dad lends a helping gloved hand to the doctor. Midwives capable and trained to gloved hands. And it's nice too because you know, without adding too much responsibility, gets to participate in the birth. And yeah, babies are slippery. What about duelas And you know, honestly, I'm not sure I could have fit one in my room because I literally had everyone in there. But a lot of my friends have duelas, and a lot of people I've talked to you on

social have had dulas are planning on having dula's. Dulas are amazing. Yeah, I am a huge Dula fan. And if I had my way, and hopefully one day I will, any mom who wanted a dulah would be provided a dulah and it would be covered by insurance. So moms who needed that support most like single moms or military moms, would definitely get it. And doula is a concept that dates back to the days of ancient Greece, but it has for sure made to come back. Dulah it's your

designated support person. She and sometimes say there are few maale duelas out there, is by your side the entire time you're in labor, even before you head to the hospital. She does not take the place of your partner and

your coach. She's more of a supportive supplement. She's there to give you soothing, massages to get you into more comfortable positions to comfort you, to cheer you on, and plus answer any questions you have when there's no doctor or nurse around, because often they're definitely not going to be in the room all the time like she is. And also advocate for you when you're too exhausted or

you're too overwhelmed to speak up for yourself. And she's she's going to help guide you when it's time to push, and she's gonna help you get started on breastfeeding. And she can even stick around postpartum. There are postpartum tools, and that's when you're probably gonna need the support just as much, if not more. What a doula won't do is deliver your baby. She'll leave that to the medical professionals. And we are going to talk more about Dula's later

on in the episode. My gosh, I want a duela in life just to like guide me through. Okay, now, can we speak my language here? Epidural? You know my opinion pro epidural, But what's your opinion here? I think you know this, but my opinion is it's your decision, a hud your decision, a thousand percent your decision, assuming there's no medical reason why you need to have an epidural or any other form of anesthesia. Your opinion is the only one that matters. Nobody else gets to vote.

I know it's a hot button issue, and I don't want to push anyone's buttons out there because that is so not what we do here on what to expect right now, Mom, we don't. But I do firmly believe it's your body, your birth, and your choice. And epidurals are safe. You know, they're mostly effective. They don't sedate the baby. They don't slow down your labor, though they might possibly slow down when it comes to pushing, you

might be pushing a little bit longer. But you can have one anytime you'd like during labor once you get to the hospital. Of course, you can't do that at home, and as soon as you can get an anthesiologist. But you know, you may have heard that how being an epidural increases your risk of a c section, but it doesn't. And what you won't be able to do if you have an epidural is have flexibility in your labor and

delivery positions. Since you won't be mobile, you're not going to be able to walk around even if you have the so called walking epidural. You're gonna be hooked up to a monitor and an i V and probably a catheter, and so you'll have to stay mostly in bed. But the bottom line is, if you'd like your bottom line to be as pain free as possible during labor and delivery, you can feel good or even great about checking epidural

please on your birth plan. I mean, on the other hand, you can feel just as good about checking unmedicated please if that's your labor and delivery bist case, that's the birth you've always dreamed of. And you can always change your mind in the moment if you decide you want an epidural, or you decide I don't need one, after all, everything's going pretty quickly. I can handle this either way.

Here's the thing, though, Any labor and delivery that results in a healthy baby and a healthy mom is a success. That's whether it's medicated or unmedicated, vaginal or cesarean. And don't let anyone anyone tell you otherwise. Here's distressing less and enjoying those last weeks before babies arrival more. You can do this, Mama, And as we always say, Emma, if you can do it, anybody can do it right.

You know that's really true because like, honestly, I think the bottom line is that you can't let anyone decide for you, not the Peanut Gallery, not even baby Daddy. If he's like no epidural, you say yes the pidarl you win and just have a beautiful labor and delivery. You got this right, absolutely, baby a baby belof I need you, Oh how I need you. Thanks for listening. Remember I'm always here for you. What to Expect is always here for you who are all in this together.

For more on what you heard on today's episodes, visit what to Expect dot com slash podcast. You can also check out what to Expect when You're Expecting, What to Expect the First Year, and the What to Expect app. And we want to hear from you. Connect with us on our community message board or on our social media. You can find me at Heidi Murkoff and Emma at Emma Being w t E and of course at What to Expect. Baby Love is performed by Riley Biter. What

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