by: Dr. Nicole Lackner, D.C.
It has been our experience that most pregnant women are unaware of the right’s and choices they have, and need to make, during their pregnancy, birth and postpartum.
Many women are robbed of their birth experience because they haven’t properly planned.
Over the last few decades, artificial practices have changed the birth process from a natural physiological event to a very complicated medical procedure. Too often I hear from patients: “If only I would have known that I had a choice, I would have done things differently.” Many women have become so disconnected from their bodies and do not trust their own innate ability to give birth naturally.
Today many drugs are utilized and invasive procedures performed. Some of these procedures are sometimes performed unnecessarily and can be both harmful and damaging to both mother and child.
Many well-intentioned health care providers do not have the scientific data to support common obstetrical practices. Most parents are unaware that the American Academy of Pediatrics’ Committee on Drugs has stated that there is NO drug, prescription or over the counter medication, that has been proven healthy for the unborn child. The pregnant woman not only has the right but the responsibility to question and research the decisions being made both for her and on her unborn child’s behalf.
A pregnant woman that becomes actively involved in her pregnancy and birth can help alleviate stress and minimize worries and fears, thus allowing her to enjoy her pregnancy.
Two of the most powerful ways a woman can plan for her birth experience is writing her birth plan and picking her birthing team. Her birth team can include some or all of the following: a Midwife (certified nurse midwife or lay midwife), Obstetrician, Chiropractor, Doula (prenatal, labor & birth support), Bradley or Lamaze Instructor, Lactation (breastfeeding) Consultant/Counselor, Massage Therapist, Acupuncturist, Pediatrician and Post-partum Counselor.
Many variables, including the location of the birth (home, water birth, hospital birthing room vs. hospital chair delivery room or birthing center) may affect whom you will choose for your birthing team.
There are so many choices to consider, that the more thought out and detailed a pregnant couples birth plan is, the greater the possibility of having the birth experience they desire.
Ensure that you share your birth plan with all members of your team. During your prenatal care, ask your caregivers their views on certain procedures, level of invasiveness (ie: vaginal exam) at each visit and frequency of visits. Find out what kind of prenatal testing they do routinely vs. a high-risk pregnancy, ultrasound frequency, alpha-feto protein, non-stress test, amniocentesis, and other blood tests. Ask your birthing team their views on anesthesia during birth, their c-section and episiotomy rate, how they feel about a VBAC, childbirth classes, nursing and testing in women over 30.
The following will describe the most significant procedures, alternatives and choices under each stage of labor you may want to consider for your birth plan:
The onset of Labor-
Your choice between a spontaneous (starting on its’ own) vs. self- induced (walking) vs. medical or surgical induction (IV: Pitocin), starting your labor at home vs. hospital.
How soon before going to birthing venue? At onset of labor or waiting for active labor to begin vs. going to hospital to be checked and sent home until active labor has begun.
1. Hydration/fluids. During labor will the mom be given water, fruit juice, ice chips or IV fluids? Under what circumstances are certain fluids given only.
2. Labor Positions. The worst position is on your back. Walking during active labor should be encouraged.
3. Others Present. Can husband, siblings and your support team be there the whole time?
4. Vaginal Exam. Who and how often will this exam be performed? Are sterile gloves and sterile lubricant used? (Gloves and lubricant sealed for one time use is prefered).
5. Fetal Heart Monitor. Is this monitoring done internal vs. external? When and how often performed? Will the Doptone (ultrasound) or fetoscope be used? Have I researched the side effects on the developing baby when multiple routine ultrasounds are performed?
6. Pain Relief. Pain relief can come in many forms: relaxation, breathing techniques, changing positions, chiropractic, acupuncture, laboring in water, medications, regional anesthesia (epidural, spinal, etc) or IV drugs.
7. Augmentation of Labor. You may choose to speed up the progression of labor with walking, changing positions or artificial means of medication i.e. pitocin.
Positions. Mother’s choice: on her side, birthing chair/stool, in water, squatting with “squat bar”, on her back with/without stirrups.
Augmentation of birth. Gravity enhanced positions are more effective than prolonged pushing on command on your back. An episiotomy may occur (a surgical cut to the perineal area) for use of forceps or vacuum extractor.
An episiotomy may be avoided through prenatal perineal and birth perineal massage and hot compresses. If an episiotomy is performed discuss local anesthesia, stitches and ice packs after birth.
Ambiance. Lighting, music, noise level.
Mom’s Chiropractor present.
To ensure the labor progresses naturally. Having mom’s pelvis/ sacrum aligned chiropractically allows for an easier birth through the birth canal for both mom and baby therefore less intervention. If labor halts, her chiropractor would be called in to adjust the spine and pelvis that may have misaligned during the birth process. Studies show pregnant women receiving chiropractic care prenatally have less back labor, use less pain medication and have shorter labors
Chiropractic Care. If would like mom and baby’s spine and nervous system evaluated after birth, let your birth team know.
Cord Cutting. You may choose to clamp and cut the placenta after it stops pulsating (After all the blood has gone into the baby) vs. clamp and cut immediately.
Airway. Your choice to not suction unless necessary i.e.: meconium (the baby’s first bowel movement) present. Ask for a respiratory therapist to evaluate your child.
Warmth. You may choose to keep the baby skin to skin with mother or utilizing a warming table/lamp.
Location of Baby. You may choose that the baby be kept with the mother and nursed/fed as desired (rooming in) or taken to the nursery and kept for newborn care.
Eye Drops. You may sign a waiver stating you do not want drops administered in your baby’s eyes immediately following the birth or ointment administered within one hour.
Feedings. The mom may choose to breastfeed on demand (no sugar water, pacifiers) or formula feed on demand.
This is the most common surgical procedure done without anesthesia in the U.S.A. America is the only country in the world that routinely circumcises their newborn males. Eighty five percent of the world’s men are not circumcised. Many doctors do not adequately counsel parents on the actual procedure and risks. Most parents are not present and do not have any idea of what the baby actually experiences. With any surgical procedure there are risks. There are many misconceptions about circumcision that are not backed up with medical research or studies. Parents may choose not to circumcise. If the parents choose to circumcise, they may choose to be present, to use anesthesia, to have it performed in the hospital or out of the hospital.
Discharge from Facility.
The parents may choose when to be discharged (if everything goes well). Parents may wish to find out if their hospital discharge will be an early release (6-12 hours after birth) or in the case of c-section how many additional days before mom and baby can go home.
Cesarean Birth. Under what circumstances will your OB perform a c-section? What indicates planned or emergency? Will my partner and birth team be present? What kind of anesthesia? Ask your obstetrician if you want him/her to explain things as they occur and let him/her know if you want immediate and/or prolonged contact with your baby. Ask about hospital stay a discharge.
Premature or Sick Infant.
Consider the following: feeding: nursing/pump breast milk or formula feeding, contact with baby, support groups.
Death of baby.
Consider contact with baby (while in critical condition), hold baby while dying, unlimited contact after death, photographs etc and what type of support is offered.
Information is power. The more informed we become, the better decisions we are able to make. Preparation and having an action plan can make some very stressful situations less so. Decisions made out of panic and fear, are rarely our best ones. The birth of your child, you will never forget. Take control. This is your birth…your way.
Warner, Dr.Theresa, D.C., FICPA, “The Pregnant Patients Rights”. The Chiropractic Journal, April 1997, pg 26. (Article)
Jenkins, Mark, “Separated at Birth – Did Circumcision Ruin Your Sex Life”, Men’s Health Magazine, July/August 1998, pgs 130-135, & 163.
Fallon, Dr. Joan, D.C. Textbook on Chiropractic & Pregnancy. International Chiropractors Association, Arlington, Virginia, 1994, pgs 57-59.
About the Author:
Dr. Nicole Lackner, D.C., a 2000 Palmer College of Chiropractic graduate, is a Gonstead practitioner, whose emphasis is on pediatric and family care. Her practice has grown to include special needs children and adults. She has been invited to speak locally and
at chiropractic colleges and coaching groups nationwide. She has been the subject of articles in both mainstream and chiropractic media. She is also the founder and director of the Holistic Health Center of Peoria. In September 2011, she was a recipient of WEEK’s 25 Women in Leadership Award for Central Illinois.