Childbirth Choices

Choosing a Health-Care Provider

Creating a Birth Plan

Choices WHO:

Obstetrician Nurse-Midwife General Practitioner

WHERE: Hospital

Traditional – labor room and delivery room

Birthing suite

Alternative Birth Center

Home Birth

Choosing an Obstetrician What kind of doctor do we need? Is the doctor well-qualified? Will the doctor be available if labor begins at an

unexpected time? What hospital is the doctor affiliated with? Will the doctor allow the father in the delivery

room (what are the hospital procedures)? How much will it cost (do they participate in your

insurance plan)?

First Visit to the Doctor Diagnose pregnancy Thorough physical examination Full medical history Various tests – weigh, measure, heart and pulse rates,

blood and urine samples, blood test, PAP test for cervical cancer

Pelvic examination Set up regular check-ups Explains aspects of good prenatal care, nutritional

needs, environmental concerns, etc.

Tests, Etc.Throughout pregnancy, weight and fundal height is monitored,

urine is routinely checked for protein and glucose, baby’s heart rate is checked

First trimester Blood tests – HcG, plasma protein Ultrasound

Second trimester Blood test – Alpha-fetoprotein, etc. Amniocentesis, Chorionic villus sampling if necessary

Third trimester Glucose tolerance test Fetal monitoring

Certified Nurse-Midwife Registered nurses who receive specialized

training in obstetrics Work both in hospitals or free-standing

birth centers

Alternative Birth Centers Only one in the Pittsburgh Area Home-like atmosphere No specialized equipment to handle

emergencies, therefore they do not handle high-risk pregnancies

Home Birth May be attended by a midwife or doctor in some rural areas

Doula Receive specialized training in childbirth Hired to be an advocate or childbirth

companion or coach Can also be hired post-partum to help with

the baby

Birth Plan Put your wishes in writing so health-care

professionals know what you want Things to include – your wishes in regard

to routines and care of the baby; who is allowed at the delivery, etc.

Prepared Childbirth (Lamaze) Valuable for information – what to expect Classes where couples learn techniques

that will help a woman maintain control of her body during childbirth

Special breathing and muscle control exercises

Relaxation techniques Special eye-focusing exercises

Non-medicinal Pain Relief Accupuncture Hypnosis Transcutaneous electronic nerve stimulation Laboring in water (jacuzzi) Relaxation and positive visualization Other – music, massage, position change,

counter-pressure, support, adequate hydration

Cesarean Section Operation whereby baby is delivered through an incision in

the abdomen and uterus Recovery period at least 10 days longer than vaginal

delivery Reasons:

Pelvis may be too small Birth canal may be infected Mother had one before Breech presentation Multiple births Fetal distress