Plan of natural childbirth in the maternity hospital. Birth plan: preparing for natural childbirth in the maternity hospital

If you have already decided to give birth in a particular maternity hospital, have found a doctor who you completely trust, but want your child to be born as naturally as possible, you should talk to the doctor about this in advance.

Of course, it is impossible to foresee everything - if any problems arise during the birth process, part of the plan (or even all) will have to be abandoned. However, if nothing threatens your health and that of your child, then a number of medical procedures are at the discretion of the woman in labor and the obstetrician.

These points should be discussed with the doctor - here is an approximate list of such questions.

If you are set for the most natural childbirth, then:

• should be able to come to the maternity hospital with contractions - if, of course, you have the opportunity to get to it in a reasonable time;

• during contractions, you should be allowed to take a comfortable position, move freely, drink water;

• you should not have an amniotomy (opening of the membranes), or do it only after the cervix is ​​almost completely dilated; it is desirable that the bubble burst itself;

• any medical manipulations performed on you (if we are not talking about emergency actions) must be coordinated with you, moreover, you must be aware of the indications for their implementation, as well as the possible consequences;

• refuse to stimulate labor activity unless absolutely necessary;

• try to do without epidural anesthesia - there are discomfort during natural childbirth, but they are quite tolerable;

• refuse episiotomy (surgical dissection of the perineum), in any case, it should not be planned;

• the umbilical cord should be clamped only after the end of the pulsation, the newborn should be on the mother's stomach for this time;

• no later than half an hour later, the child must be attached to the breast and left with his mother for at least an hour;

• the newborn must stay with the mother around the clock;

• the baby should not be supplemented and supplemented - this is an important condition for the development of breastfeeding;

• vaccination of a child in the maternity hospital can only be carried out with your consent.

Why is it important to comply with these conditions?

Medical induction of labor

With the natural course of childbirth, a woman has time to adapt to gradually increasing pain sensations, most mothers describe them as “tolerable”. Oxytocin injections make contractions violent and frequent. Such artificial acceleration of labor not only forces the use of painkillers, but also increases the risk of uterine bleeding. Moreover, the child may not be ready for such a speedy birth - his lungs will not have time to prepare, which threatens him with asphyxia.

” Moscow neonatologist Tatyana Alexandrovna Bachurina believes that additional portions of oxytocin in the general circulatory system of the mother and child put the baby in a state of stress, and even uses the term "children stressed by oxytocin."

“These children have neurological symptoms, often in the form of a hyperexcitability syndrome, and subsequently often neurotic reactions, emotional and behavioral disorders, difficulties in social adaptation,” she writes in her article on home birth.

Anesthesia

Indications for the use of painkillers and, especially, epidural anesthesia, must be very serious - the pathological course of childbirth or the need for a caesarean section. Epidural anesthesia in itself is a rather unsafe procedure - from 2 to 3.4% of maternal deaths (according to various sources) are due to complications from anesthesia. But even a procedure carried out without obvious violations can provoke postpartum depression in the mother, and in the child - complications during childbirth (depression of the respiratory center).

Amniotomy

Piercing of the amniotic sac is undesirable (at least up to 8-9 fingers of opening), because involuntarily it can cause labor stimulation; if the anhydrous period after piercing the bladder drags on longer than 12 hours, the doctor willy-nilly will have to decide what emergency measures to resort to to extract the child.

Amniotomy can fix , which will lead to complications in childbirth (for example, facial presentation). In fairness, it should be noted that it is very difficult to change the presentation of a child whose head has already “stood” in the birth canal, and an amniotomy performed at the wrong time can only aggravate the situation.

Piercing the bladder and the birth itself makes it harder. Bladder pressing on the cervix helps smooth and soft opening of the cervix.

” On the net you can find, for example, the results of a study conducted by specialists from the University of Liverpool (England), who studied the birth histories of 4,893 women and concluded that the amniotomy group had a higher risk of surgery and a higher risk of getting a low Apgar score.

At the same time, amniotomy had practically no effect on the duration of labor. Doctors felt that amniotomy could not be considered as a standard procedure and should only be prescribed for strict medical reasons.

Episiotomy

The Cochrane Collaboration, an international non-profit organization that studies the effectiveness of medical devices and techniques through randomized controlled trials, analyzed the birth histories of more than 5,000 women in 2009. The researchers concluded unequivocally that: “A policy to limit the use of episiotomy appears to have a number of advantages… there is less trauma to the posterior perineum, fewer sutures and complications, and no difference in most pain measurements and in the incidence of major injuries.” vagina and perineum. However, there is an increased risk of injury to the anterior perineum."

Removal of original lubricant

A lubricated baby may not look so attractive, but during the first day it effectively protects the newborn's skin, allowing him to adapt to the new environment.

Newborn eye care

A stage that most moms simply don't pay attention to. Meanwhile, the need for this procedure is not at all obvious, not to mention the fact that our maternity hospitals still use such potent drugs as silver nitrate and sodium sulfacyl. If the neonatologist considers that such treatment is necessary, be sure to ask what drug will be used, today erythromycin phosphate can be considered the safest.

tying the umbilical cord

” In five to seven minutes of pulsation of the umbilical cord after childbirth, the baby can “pick up” 100-150 ml of blood from the placenta that is not at all superfluous for him.

It is only important to ensure that the child is below the level of the placenta (otherwise, a reverse outflow of blood is possible).

Early breastfeeding

Early breastfeeding (if possible, before clamping the umbilical cord) is not only an emotionally priceless moment of childbirth, a moment of very special closeness between mother and newborn, but an effective prevention of a number of pathologies - diathesis, dysbacteriosis, and other allergic manifestations. The baby should stay at the breast for at least 15 minutes (preferably an hour). Let him swallow quite a bit of colostrum at this time, the intestines will still be inseminated by an acidophilus bacillus. In addition, this is the first step to fixing the sucking reflex.

For the mother's body, the first attempts of the child to suckle the breast are a kind of signal that everything went well, and you can start working on other tasks, for example, on increasing lactation. Breast stimulation also increases uterine contractions, making it easier for the placenta to pass.

” Similar in importance is the first skin-to-skin contact. This not only calms the baby, but also allows him to “get acquainted” with the microflora of the mother (preferably also the father).

Fortunately, today there are more and more maternity hospitals that are friendly to mother and child, where such desires of a woman in labor are not considered a whim and a whim, and even vice versa - the mother is offered to attach the child to the breast and ensures that mother and child stay together from the first minutes of life. The choice of a maternity hospital and a doctor with whom you will find a common language, and who will treat your wishes with understanding, is your first responsible maternal act. Don't miss the opportunity to make it!

Article updated 7.12.2014

Prepared on the basis of material by Anastasia Gabets,

perinatal psychologist of the School "Birth for Two"

The birth plan has recently become popular and is increasingly being developed for the future, as it is very useful during childbirth. Find out what it should conclude and how to write it, because this is an important and serious event in your life!

Before going on vacation, you prepare a plan for shopping, necessary things. Similarly, before giving birth, you should ask yourself some important questions about the event awaiting you. A birth plan is useful, which will allow you to know yourself, your needs and requests, fears and doubts. It can also be an inspiration to talk with your husband or other family members who will accompany you during childbirth, so that they can figure out your plans. The birth plan also allows you to compare your own expectations with those of the hospital where you will give birth.

When to make a birth plan?

If yours runs smoothly, you can begin to add up the outlines of the birth plan at 7-8 months of pregnancy.

What should a birth plan include?

The completed plan contains a list of things and procedures that you think you need to do when your baby is born. It's worth really thinking through and discussing everything with someone experienced (a friend who has already given birth, your doctor or a midwife that you have chosen). Remember that after the start of labor, you will forget about half of the essential things, and the prepared document will be of considerable help. The birth plan should be designed in such a way that the midwife does not think that her hands are tied. In the event of a situation that may pose a threat to your health or the child, the birth plan will not play a big role. Then you need to apply such solutions that will protect both of you from danger.

Here are some suggestions for making a birth plan:

1. Your first and last name are required data.
2. Data of the doctor leading the pregnancy.
3. Details of the person accompanying you during childbirth - if you want this person to be with you until the end of childbirth, write down this information. If you wish to be yourself during some procedures, you can also indicate this. Someone's company during childbirth, outside the presence of a midwife, depends only on your decision.
4. Positions in the first and second phase of labor - determine in which positions you are going to give birth. If you are interested in active birth, remember vertical positions. Adopting a position in the depression phase sometimes depends on the customs in a given hospital. If you get a choice of position, don't forget about the force of gravity and vertical positions to help dilate the cervix.
5. Medical interventions - think about which ones you would approve of and why, and which ones you would like to avoid.
6. Affordable Non-Medical Care – Think about alternative forms of help that are soothing and relieve pain: gym ball, stairs, handkerchief, bath/birth pool, aromatherapy, massage.
7. The presence of interns - if you do not want their presence, you have the right. Sometimes it happens that students are very helpful and support the woman in labor as well as her partner.
8. Cutting the umbilical cord - who should do it? If the course of labor and the condition of the child allow it, the father of the child can cut off the umbilical cord. In some hospitals, this is done by the midwife due to reluctance on the part of the father of the child or habit.
9. The first hours after childbirth - you should be bathed, decide what clothes you should wear, you are thinking of breastfeeding already in the delivery room - think about it.
10. Baby's First Vaccinations - You may not agree to your child's vaccinations immediately after birth. In case of refusal, you must submit a statement in which you write that you refuse to vaccinate your child and understand the consequences of this decision.
11. Take your birth plan with you when you are admitted to the hospital. The plan will help staff understand your wishes and needs related to childbirth.

A very important and exciting moment in the life of every expectant mother is childbirth. In order not to forget anything and not get confused at the most fussy moment, make a plan for childbirth. In addition, it will help you tune in to the fact that the appearance of the baby is already close.

In this article, we will help expectant mothers draw up a birth plan, explain what mandatory items should be included in your plan.

Preparing for childbirth requires a specific plan that will help you understand how you are managing your birth, what your needs are, what you are afraid of, etc. With the help of the plan, you will be able to match your needs with the availability of the maternity hospital you have chosen. The birth plan can organize not only you, but also your family members.

So, how and when should a birth plan be drawn up?

If the pregnancy is proceeding normally, you can safely take on the birth plan at 6-7 months of pregnancy, or when you feel the need to sort everything out.

The birth plan should include all the procedures and things that you think need to be done when the baby is born. Consider each item carefully, if necessary, consult with a friend who has already given birth, and best of all with a midwife or doctor.

Such a plan is very useful when the birth begins, because it will not be easy to gather your thoughts at this moment, and after all, every woman wants the birth to go as well as possible.

You should not leave the birth plan so that the obstetrician thinks that her hands are tied. Remember that your plan will be considered in case of a normal delivery, if there are any complications, it will no longer be relevant.

What are the mandatory items you should consider in your birth plan?

First, write all the necessary information about yourself, start with your first name and medical indicators - this is very important.
If you decide that someone will be present with you during childbirth, be sure to enter the details of this person. Also, you can mark at what stages of childbirth this person will be present. Mark all the nuances.

Write down the position in which you would like to take on the first and second stages of childbirth, you can discuss these positions with the doctor and midwife in advance. And if you also write down these positions, then definitely no one will forget about your preferences.

Probably the most important item in your birth plan will be the item about medical intervention. Think about what you agree to and what you don't. Write down why you would like to avoid certain procedures.

If you have special preferences, such as alternative forms of assistance - massage, aromatherapy, bath or birthing pool, exercise ball - also indicate this.

Sometimes the presence of interns is not excluded at childbirth, if you do not want to see them, you can safely refuse them. By the way, sometimes they are very useful, as additional moral support, not only for you, but also for your partner for childbirth.

If everything goes well, you can even prescribe the condition that the father of the child, for example, will cut the umbilical cord.

Anything you want to do after giving birth should also be included in your plan. Write what the baby should be wearing after he is bathed.

If you refuse vaccinations for the baby, in the first days of his life, also write it down.

Take care of a special declaration - refusal of vaccination - this is necessary for your desire to be fulfilled.

The plan you create will help the hospital staff understand what you want and don't want. It will become an assistant for you, a birth plan will help you focus on the process and not think that you might forget something. This is an additional peace of mind for you, at such an important and exciting moment.

- important points that I have compiled to observe during the birth of our son and which can help you in drawing up your plan.

I dreamed and dreamed of natural childbirth. But when I was diagnosed with ICI and stitched on the cervix, I realized that there was no question of any kind of birth at home. At that time, we attended courses for pregnant women and there they explained to us how important it is, not only for the pregnant woman herself, but also for her team, to have a clear Birth Plan. It is clear that childbirth is an unpredictable thing and one must be prepared for anything. Therefore, this plan is needed, where it will be clearly described what and how, if something happens.

These people should have an idea of ​​what you want from your Clans. I'll give you an example. When I got stitches, the doctor who did it asked where I plan to give birth. I said that I want the most Natural Childbirth, to which he said that of course they can be here. Then I asked one question - how much time do you give before you cut the umbilical cord. The answer put everything in its place - "well, 2-3 minutes is enough." Therefore, it is very important to know in advance and make it clear to the doctor what you expect and want from your Childbirth.

I made a plan for a long time, based on my wishes. It was drawn up 2 months before the birth.

I printed it out in 5 copies and put it in a ready-made bag for the maternity hospital. Before that, of course, I gave it to my husband to read :)

So, here it is.

childbirth

1. I can move freely and walk around the room

I did not want to be tied to the bed and lie on my back during contractions and pushing. For me, as well as for the process itself, it is very important to be in motion.

2. There should be dim, dim lights in my room.

That is, natural light from the window during the day or, as in my case, candles at night.

3. My music inside the ward

This aspect was very important for me. At first I planned to listen to traditional Celtic music, but ended up with relaxing yoga music. We even bought a special column, but since everything was not planned, we forgot it at home. The music ended up playing from our midwife's iPad (it's great that she had one!).

4. Give birth in your clothes

I wanted as few associations with the hospital as possible, so it was important for me to give birth in my personal clothes. I was wearing a simple elastic bandeau dress. In the end, of course, I took it off.

5. Do not offer painkillers/epidurals

I wanted the most natural childbirth, so I considered only non-drug methods of pain relief. During childbirth, there comes a time when you begin to feel that you can not cope and many begin to require anesthesia. It is very important at this time to have a person next to you who can bring you to your senses.

6. Do not pierce the amniotic sac

That is, wait until it bursts itself. Piercing stimulates very strong and painful contractions - this is considered the stimulation of the birth process. In addition, sometimes babies are born "in a shirt" - that is, in a bubble. In my case, we went to the hospital because my bubble burst, so it was irrelevant.

7. Minimum gynecological examinations

Watching the disclosure every time the bubble has already burst at least can bring an infection, and it doesn’t carry any particular information. I was watched 4 times for the entire time of Childbirth.

8. Dropper only for medical reasons

I was against the installation of a catheter on my arm. Again, because I wanted to minimize the hospital mood. In the end, of course, I was given a catheter only because it was necessary for medical reasons - bleeding began.

9. Offer me food and water between contractions.

Yes, I ate and drank during Labor. And I think everyone should do it. It takes so much strength and energy to give birth to a baby. In general, all the fuss about the ban on food and drink came out of the fact that potentially surgery may be required. I drank red wine (with the doctor's permission) and water. I ate bananas, apples, cheese, dark chocolate.

10. Offer me new positions

In childbirth, there always comes a moment when you have to change positions in order to find the right one in which it seems to be easier for you. For example, I could not lie on my back at all. I was in unbearable pain. During the contractions, I walked, lay in the bath, sat on the delivery chair. During attempts hung on the handle from the bed. She gave birth in a delivery chair.

11. Massaging my lower back during contractions

It helped a lot with the pain. When the contraction came, I would first say “conflict” to my doula and she would start massaging my lower back. Then even words were no longer required. My husband also helped with the massage.

12. Lying in the bath during contractions

When the maternity activity was in full progress, I climbed into the bath. Warm water relaxes and helps ease contractions.

12. Use natural methods of stimulation if labor stops

Sometimes they stop. And I did not want to resume the birth process medically with the help of the synthetic hormone pitocin. Natural methods are nipple stimulation, walking, changing positions, and so on.

13. No Episiotomy

I am opposed to episio - or the incision of the perineum, which is practiced in almost all childbirth. And without any meaning. Many doctors say that this is necessary in order to prevent rupture. But even studies already say that natural tears heal much faster and more painlessly than incisions.

14. Physiological birth of the placenta

This means that the placenta should be born on its own, without the prescribed pitocin or tugging on the umbilical cord. The exception is not passing the placenta within 60 minutes or bleeding!

15. Natural relaxation techniques

This includes breathing, acupuncture, massage, rebozo, pressure. For example, it helped me a lot when they breathed each contraction together with me and massaged the lower back.

After childbirth

1. No Pitocin

This synthetic hormone, oxytocin, is often given immediately to prevent bleeding. I see no reason to do this without a strong medical indication. That is, if the birth was normal and physiological.

2. Immediate skin-to-skin contact

Put the baby on my stomach immediately after he is born. This is important not only from a psychological point of view, but also from a physiological one. Children should receive microflora from the skin of their mother (or father), and not from the hospital table. In addition, it stimulates the separation of the placenta! Well, the “plus” - it even helps children breathe, as they feel your breath and heartbeat.

3. Clamp the cord only after the birth of the placenta

Or at least give her a boost. The blood and oxygen is still supplied to the baby, so it is important to let him get enough of her. In our case, unfortunately, this did not work out because I started bleeding.

4. Husband cuts the umbilical cord

For me it was important from an emotional point of view.

5. Save the placenta for encapsulation

This requires a separate post. But the point is to dry the placenta, crush it and then use it. Yes, you understood correctly - there is a placenta. So do all the females in the animal kingdom. The placenta contains numerous hormones and bioactive substances. Its use improves the flow of milk, reduces the risk of developing postpartum depression, and gives more energy. Unfortunately we were unable to use this service as I had a partial dense placenta accreta. But next time, if possible, I will definitely use it!

6. Examine the baby on my chest

This is where he should be. And all manipulations (of course, if everything is fine) can be carried out on my chest. Or wait a few hours - for example, measuring weight and height. Emelya was examined and listened to on my chest, and only then measured height and weight.

7. Refusal of drops in the eyes

As a standard, many maternity hospitals still instill antibiotics in the eyes of children. This is done to prevent infections that can be transmitted to them from their mother. Everything is “clean” with me, so I did not see the point in completely unnecessary antibiotic therapy.

8. Refusal of vaccinations

We wrote a refusal of all vaccinations. To explain for a long time, I already wrote my point of view on this matter.

9. Do not bathe the baby

Babies are born covered with a special protective lubricant, which, in my opinion, is simply unnatural to wash off. In addition, with the use of any chemical agents. We did not bathe Emelya, but only wiped him.

10. Consultation of a specialist in breastfeeding

No matter how rich my theory of breastfeeding was, I still had no idea how to breastfeed. Therefore, a knowledgeable person who showed how to properly apply to the chest came in handy. But my husband helped me a lot. It was he who helped put Emelyan to the chest and insisted on trying new positions if Emelya refused to take the breast.

11. The baby is always with me or with dad

My birth ended in heavy bleeding where I lost 1.5 liters of blood. It is clear that I spent the first 12 hours in intensive care. At this time, our baby was with dad. It lay on his bare chest and "enriched" with his microflora. In addition, my husband brought Emelya to me for feeding until I was transferred to our joint ward. If this item was not in my plan, Emelyan would go to the nursery and lie there alone, which in my opinion is absolutely unnatural.

Just in case

1. Do not hasten/induce labor

Only if there is a real threat to my life or the life of the baby.

2. Explain any interference to me first and then give time to discuss it with your team

In my case, the moment came when the progress of labor activity stopped. The baby was premature (I gave birth at 35 weeks) and he didn’t lie as it should, so I couldn’t relax and the dilation was 8 cm, but at a contraction no more than 6. In the usual “full-term” case, I would have been given Pitocin, but since it was a premature birth - there were two ways out. Or a caesarean or try an epidural, which will help open up to 10 cm, and then give birth without her. When the doctor told me about it, I couldn't believe it. In my eyes, it was the ruin of my dream of natural childbirth. But my midwife and doula agreed with the epidural as a necessary part of my Labor and helped me understand and accept it. As a result, she helped me open up to 10 cm, and I already lived through the attempts with all the delights of the birth process!

C-section

1. Only strictly for medical reasons

In case of threat to my life or the life of the baby.

2. "Soft" CS

In Russia, only relatively recently began to practice this type of operation. I will definitely write a separate post about it. "Soft" it is called for many reasons. Below are some of them:

• Before the operation, insert a sterile bandage into the vagina and then wipe the baby's mouth, face and body with this bandage in the first 2 minutes after birth (when it lies on my chest). This is necessary in order to give the baby the mother's microflora, which he is deprived of, since he did not pass through the birth canal.
• My team (husband, doula and midwife) with me in the operating room
• I want to see the birth of my baby (that is, do not put up a fence)
• If possible, give the umbilical cord a pulse
• Husband cuts the umbilical cord
• Leave my one hand free so I can hold the baby
• Immediately attach the baby to my chest, if not, then to my husband

All points were fulfilled in my situation. Because I knew what I wanted. Because I had a plan. And of course, because we gave birth under a contract with the “right” doctor in the “right” maternity hospital, who shared our views on natural childbirth. And most importantly, we gave birth with the “correct” midwife, not a hospital one, but our own, who taught courses with us. which we knew personally. And I know that I would give birth again exactly there, with the same people!

* I am now actively mastering Instagram, my thoughts are about pressing problems and not only on evgenia_happynatural

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