Pregnancy, labor and birth can be exhilarating, but unpredictable and anxiety-provoking as well: How will my changing body feel during pregnancy? How long will labor last? Will I need any medical intervention?
The good news: You can reduce some of the uncertainty — even before your first prenatal visit. Making decisions early on regarding your healthcare provider, hospital or the type of labor you prefer can help make for a more empowering, less out-of-control birth experience.
Doctor, Midwife or Nurse Practitioner?
Provider options may include a doctor, a midwife or a nurse practitioner — all, perhaps, with varying ideologies. It’s important that your provider’s philosophies about pregnancy and labor support your own. By ensuring this alliance, you’ll feel comfortable allowing your provider to advocate for you, with fewer surprises in terms of management or intervention.
Shared decision-making as opposed to informed consent can help keep you an active participant in your pregnancy and labor, and could help to sustain a more satisfying experience for you and your family.
Talk to your provider about induction policies, frequency of prenatal visits or any routine testing. Find out if a midwife works independently or in a collaborative setting. Become familiar with the partnership, so any transfer of care or co-management is less of a surprise later on.
Hospital or Birth Center?
The atmosphere you choose in which to labor can also influence your overall birth experience. You may need to research the options available in your community. Take tours, and talk to those who have had babies at local hospitals and birth centers.
Ask questions about hospital protocols, monitoring options, or whether there are opportunities for hydrotherapy in a tub or a shower during labor. Imagine yourself in the space, and trust your gut about whether you would feel safe being vulnerable there.
Anything that familiarizes the space potentially can ease your anxiety in labor. This can decrease your sense of pain and make your overall experience more manageable.
Natural Labor or Epidural?
Studies show that women with continuous labor support have shorter labors and more satisfying birth experiences. Decide who will be with you during the earlier parts of labor and at your side during the birth. Also think about whether you’d like a natural labor (no pharmacologic pain relief) or an epidural.
Stating early on what you prefer in labor will provide you with more time to make sure your providers and the hospital can offer the experience you desire.
Regardless, it’s really difficult to learn about labor once you’re in labor. Childbirth education classes can help you create a vision of what you’d like your labor to look like.
Thinking through all aspects of your pregnancy and labor can help you start a dialogue with your labor partner and provider about creating a more positive birth experience.
Sarah Kleinman is a Certified Nurse Midwife in Boston who delivers babies at Beth Israel Deaconess Medical Center and Newton-Wellesley Hospital.
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