• Rebekah Porter

Discussions Before Birth


*Disclaimer: This in no way takes the place of a childbirth class. Nashville has many wonderful classes from private ones to group ones. If you have the time and resources, please attend a class. You will learn more and be better prepared to make wise choices at your birth. If you want a childbirth class you can do it online, in your home or in a group setting.


Many parents go into labor unprepared for the questions they will be asked and the decisions they will have to make. While you are in labor is not the time to be learning and making life changing decisions. It is very easy to get educated BEFORE labor starts. I have come up with a simple list of questions to ask your partner and care provider so that you are ready to make a decision when the time comes.


Where do you want to deliver? 

Your choices are at home, a hospital, or a birth center. Visit the Birth Options and Hospital Reviews page to learn about Nashville options and c-section rates.


How do you feel about being induced vs. waiting for the baby to come when the baby is ready?


How do you feel about being induced vs. waiting for the baby to come when the baby is ready?


Do I need an I.V. in labor or can I keep myself hydrated?

Here is an article to read about it.Eating in Labor: Facts and Myths Eating in Labor "Well, simply put, it (an I.V.) is said to be a precautionary measure ” in case you have to be put under general anesthesia.” The fear is that if you vomit you could maybe potentially aspirate food into your lungs." This is not likely and is actually based on a study from 60 years ago.  "So if you have an opportunity, ask your care provider his or her policy about eating in labor. Drinking and eating in labor is safe…and it is better for you and your unborn baby. "


Do you want your placenta encapsulated?

Placenta encapsulation is a process in which, immediately following the birth of your baby, your placenta is dehydrated and ground into a course powder, which is then placed into small capsules that look exactly just like any other vitamin or supplement we might take. Mothers then consume these capsules to help them rebound from the birth, avoid postpartum blues, and boost their milk supply.

Here is an article to read more.


Are First-Time Mothers Who Plan Home Birth More Likely to Receive Evidence-Based Care?

abstract


"Choices for newborn baby care procedures begin immediately at birth.  The best preparation is to have considered them and decided beforehand what procedures you want or would rather decline for your newborn.  For a hospital birth, there are numerous routine procedures which can be administered, delayed or even refused.  Unfortunately, first time parents are often unaware that many of these routine procedures are not grounded in evidence-based practice, but are rather the product of ease and access for staff." Click here to visit Giving Birth Naturally. You will find a list of newborn routine care and several articles about the Pros and Cons.

The most commonly performed routine newborn baby care procedures to consider are:

Suctioning, Delayed Cord Clamping Vs. Immediate Cord Clamping, Newborn Vitamin K Injection, PKU Test, Silver Nitrate or Antibiotic Eye Ointment, Hep B Vaccine, To Bathe or Not to Bathe, Circumcision If you don't agree or don't want some of the "normal" newborn procedures. You will need to sign a consent form.

Why do I want delayed cord clamping for my baby?

Many maternity care providers continue to clamp the umbilical cord immediately after an uncomplicated vaginal birth, even though the significant neonatal benefits of delayed cord clamping (usually defined as 2 to 3 minutes after birth) are now well known.

cord clamping article

Here is a video on why to delay cord clamping.




Do you want vitamin K shots?

article


Do you want your baby circumcised?

http://www.doctorsopposingcircumcision.org/DOC/statement0.html

http://www.intactamerica.org/resources

http://www.askdrsears.com/.../whether-or-not-circumcise

http://www.psychologytoday.com/.../myths-about...

https://www.youtube.com/watch?feature=youtu.be...

Do Health Benefits outweigh the risks?

Article on U.S. rate dropping.

Here is a map for the national stats on circumcision. 





Some great websites to explore and learn more about your birth choices:

Improving Birth:

It’s about women being capable of making safer, more informed decisions about their care and that of their babies, when they are given full and accurate information about their care options, including the potential harms, benefits, and alternatives. Then, within that choice, they are treated with dignity and compassion.”

Evidence Based Birth: We find the highest-quality research evidence and turn it into informative summaries that can be used by consumers, childbirth educators, and care providers! Giving Birth Naturally: Whether you do or do not choose to use one of the formal methods of childbirth, you can still have a pain-free natural childbirth.  The key to be finding what works for you.  It may be more convenient to use a method that has tools pre-assembled for your use, but this might not suit everyone.

The preferred course of action is to educate yourself on your choices in childbirth, then select the path that best suits you, your family, and your desired birth experience.

Free on-line Childbirth Class: leslynotes.com  Created by a Lamaze Instructor with 14 years of experience. Great information, skills, and videos.


Unsafe Medications in Labor:

Below is a minimal listing of off-label use of medications in pregnancy, labor, delivery and lactation.  These are not FDA-approved and pose serious risks to mothers and their children:

Cytotec/Misoprostol Approved Use:  Prevention of stomach ulcers Unapproved Use:  Abortion, pregnancy, labor, delivery and lactation Common Off-Label Use: Labor induction, abortion, cervical ripening agent, postpartum bleeding Specific Warnings:  "Cytotec is not approved for the induction of labor and delivery or abortion.  Cytotec is a synthetic analog of prostaglandin E1, and as such can induce or augment uterine contractions.  Cytotec has been used outside of its (FDA) approved indication, as a cervical ripening agent for the induction of labor or abortion, in spite of specific contraindications to its use during pregnancy." Both the FDA and its manufacturer issued statements in 2000 that it is not to be used for induction of labor, delivery, or abortion.  Drug has a picture of a pregnant woman with a line through it as a universal symbol to avoid while pregnant. Documented Risks: Uterine rupture, maternal death, fetal death, uterine hyperstimulation, uterine perforation, amniotic fluid embolism, vaginal hemorrhage, retained placenta, fetal bradycardia, hysterectomy Source: Physician's Desk Reference page 2991

Prostin E/Dinoprostone Approved Use: Abortion Unapproved Use: Pregnancy, labor delivery or lactation Common Off-Label Use: Cervical ripening for artificial labor induction Specific Warnings: "Prostin e2 vaginal suppository should not be used for cervical ripening." "Dinoprostone, as with other potent oxytocic agents, should be used only with strict adherence to recommended dosage. Dinoprostone should be used by medically trained personnel in a hospital which can provide immediate intensive care and acute surgical facilities." Documented Risks: Vomiting, diarrhea, nausea, fever, headache, chills or shivering, backache, joint inflammation or pain, flushing or hot flashes, dizziness, anthelia, vaginal pain, chest pain, dyspnea, endometritisis, syncope or fainting, vaginitis or vulvitis, weakness, muscle cramp or pain, tightness in chest, nocturnal leg cramps, uterine rupture, breast tenderness, blurred vision, coughing, rash, myalgia, stiff neck, dehydration, tremor, pain, wheezing, cardiac arrhythmia, skin discoloration, vaginismus, and tension. Source: Physician's Desk Reference page 2638

Stadol/Butorphanol Tartrate Approved Use: Narcotic pain relief Unapproved Use: Pregnancy, labor, delivery and lactation Common Off-Label Use: Labor and delivery pain relief Specific Warnings:  "40 times more potent than Demerol: 2mg Stadol = 10mg Morphine; crosses placenta in minutes and enters all fetal organs, including the brain and central nervous system; perform Neurobehavioral testing on all infants exposed to the drug during delivery." Documented Risks:  Respiratory distress, cardiovascular dysfunction, psychotic effects, motor impairments, bladder impairments, lung dysfunction Source: Physician's Desk Reference page 2991

Catapres/Clonidine HCL Approved Use: Hypertension Unapproved Use: Pregnancy, labor, delivery or lactation Common Off-Label Use: Labor and delivery anesthesia Specific Warnings: "No adequate, well-controlled studies have been conducted in pregnant women.  Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed." Source: Physician's Desk Reference page 968

Morphine Approved Use: Narcotic for severe pain relief Unapproved Use: Pregnancy, labor, delivery and lactation Common Off-Label Use:  Labor anesthesia Specific Warnings: "Labor and Delivery: Intravenous morphine readily passes into the fetal circulation and may result in respiratory depression in the neonate.  Naloxone and resuscitative equipment should be available for reversal of narcotic induced respiratory depression of the neonate.  In addition, intravenous morphine may reduce the strength, duration and frequency of uterine contractions resulting in prolonged labor. Epidural and intrathecal administered morphine readily passes into the fetal circulation and may result in respiratory depression of the neonate. Controlled clinical studies have shown that epidural administration has little or no effect on the relief of labor pain. Close observation should be carried out for 24 hours following exposure." Source: Physician's Desk Reference page 563

Phenergan/Promethazine Inj Approved Use: Nausea Unapproved Use: Obstetrical sedation during labor Common Off-Label Use: Sedation during labor Documented Risks: Impaired platelet aggregation in the newborn which can cause intracranial hemorrhage in the fetus and newborn Source: Physician's Desk Reference page 3416

Metoprolol/Lopressor/Apo-Metoprolol/Apo-Metoprolol (Type L)/Betaloc/Betaloc Durules/Lopresor/Lopresor SR/Novometoprol/Nu-Metop Approved Use: Hypertension, Beta-Adrenergic blocker, Sympatholytic Unapproved Use:  Pregnancy, labor, delivery Documented Risks: Toxic at high doses causing fetal loss and decreased neonatal survival, crosses human placenta, use of some beta-blockers including metoprolol in the second and third trimesters is associated with intrauterine growth retardation and neonatal beta-blockade. Source: Physician's Desk Reference page 606

Compazine/Prochlorperazine Approved Use: Nausea and vomiting Unapproved Use:  Pregnancy, labor, delivery and lactation Common Off-Label Use: Morning sickness, hyperemesis gravidarum Documented Risks: Prolonged jaundice, loss of neurological control of speech and hands, hyperflexia in infants, hyporeflexia in infants Source: Physician's Desk Reference page 3077

Elective use of medications in pregnancy, labor, and delivery exposes the mother and her unborn child to risks that would otherwise not exist. Unfortunately, most women do not know to ask about the safety of these drugs, as they assume their safety has been assured. In some cases, women are even told these drugs are perfectly safe.

For these reasons, it is vital to be an informed consumer, asking questions surrounding any and all procedures during pregnancy and childbirth to preserve the safety and well-being of both mother and child.

*Taken from GivingBirthNaturally.com


#newbornprocedures #decisionsbeforebirth #evidencebasedcare #childbirthclass #pregnancy

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