Birth Plans

Environment for Labor

Many non-pharmacological methods of pain relief require you to relax in some way, having an environment that promotes relaxation can improve your chances of laboring without medication. Even if you choose to use medication during your labor, the environment sets the tone for your labor and may play a part in your mood, how others treat you during your labor and your memories of your baby's birth.

Every choice you make has an impact on the environment in which you labor.

Birth Location

You have a choice about where you give birth. Most communities have at least one hospital, many have two or more within an hour drive. Some women enjoy giving birth in a hospital because knowing they have access to medications, emergency equipment and a variety of medical professionals gives them comfort. Other women find that the policies and procedures in hospitals leaves little room for any decision making on their part. Some women find that hospital staff urge or even pressure them to use interventions they prefered not to use. Some women also find the move to the hospital and the standard two day stay to be an unnecessary disruption to their lives.

Some communities have an out of hospital birth center. Some women enjoy giving birth in an out of hospital center because having a place to go where supportive professionals have access to tools that help them have a natural birth gives them comfort. Many women also find that the shorter stay at a birth center allows them to give birth and return home with very little interruption. Other women feel that the possibility of a hospital transfer in an emergency or to use some medications prevents them from feeling relaxed. Some find that policies in birth centers prevent them from feeling totally free to give birth.

In every community you have the option to give birth at home. Many women enjoy the freedom they have to labor in their home and go about their day without worry about having to move. Some women enjoy the relaxing atmosphere they are able to create by having only those individuals present who are invited. Women who give birth at home enjoy the time they are able to spend with their midwife. Some feel that unless their is a problem, there is no reason to enlist the help of health care providers. Other women feel that lack of adequate medical home birth support in their area makes home birth too risky. Some find that the social pressure to give birth in a hospital makes them uncomfortable with a home birth.

Clothing

There is no rule that says you have to wear a hospital gown complete with open back to give birth. Anything that will give you freedom to move and makes you feel comfortable is acceptable. If you give birth in a hospital, you may be asked to labor without pants to make vaginal exams easier. Some women find that wearing the hospital gown gives them the comfort of knowing their clothing will not be soiled. Other women find that wearing the hospital gown makes them feel like a patient rather than a healthy woman. Some also prefer to wear their own clothing for modesty reasons or because a special garment makes them feel comfortable. Some women prefer to have control over what they are wearing in their new baby pictures.

Hydration

In a normal unmedicated labor, there should be no need for an IV. You can keep yourself well hydrated by taking sips of water or sucking on ice chips between contractions. If you choose to have antibiotics during labor, they may be administered through an IV. In this case you may ask for a hep lock or hep well, which will allow the nurse to hook up the IV when necessary and unhook it after the antibiotics are completed without having to insert another needle if a second round of antibiotics is needed. Some women find having an IV diminishes mobility, although the amount is highly variable. Some women find an IV makes them feel as if they are sick. Some women are uncomfortable with the thought of an IV being inserted. Some pain medications require the use of an IV before they can be administered. If pitocin is used, it will be administered through an IV.

Support Persons

The people you have chosen to labor with you will determine the atmosphere of the labor room. It is important that you have chosen a support team that understands how you want to handle your labor and what you expect of them. Some women find that having many friends and family allows them to feel comfortable and well cared for. Other women find that having too many people is distracting, and they prefer to have only one or two special support persons. Other women feel that their baby's birth is a time of special family bonding and prefer to be with only the baby's father and siblings.

Mementos

The way in which remember your labor can be greatly affected by the mementos you keep. Some women want lots of visual documentation and ask family or friends to take pictures and/or video of as much as possible. Other women want pictures, but prefer that the photographer be aware of modesty issues and not shoot from angle that show body parts. Other women choose not to have their picture taken during labor, instead they focus their photo opportunities around holding the new baby.

You may also have options for foot prints, id bracelets and other items that are available at hospitals or birth centers. Some women like to have pictures of the nurses or doulas who helped them labor. Some women like to have an audio recording of part of their labor.

Don't Offer Medication

If you want to give birth without medication, it may be necessary to include a line in your birth plan that states you understand medication is available, but please do not offer it. Some women find that well meaning nurses or doctors offer medication even though they know the mother wanted to give birth naturally. Such offers of "relief" are hard to turn down because women in labor are highly suggestible.

Lighting

Most women prefer a dimly lit or dark room when laboring, though some like it bright and cheerful. Does your birth place have windows that could or should be covered? Are the lights on dimmer switches or can you use a variety of light fixtures to get only as much light as you want? Can you use candles for mood lighting?

Sounds

Some women want soft or gentle music playing while they labor, some women want absolute quiet. Does your birth place have a way for you to play CD?s or another source of music? Is there street noise or other sources of distracting background noise to interfere with the environment you would like?

Water

Many women find spending time in a labor tub or shower to be a great comfort measure. Does your birth place have access to a source of water for comfort? Could you rent or buy a tub to use? How easy will it be for you to use the tub or shower?

Positioning Helps

The most comfortable position in labor changes from hour to hour. A good labor environment will allow you to change your position as your labor progresses. A variety of places to sit, lean and recline as well as enough room to walk or sway and the ability to get into hands and knees positions is helpful. Could you have access to a ball, a pillow or other positioning aids?

Privacy

Regardless of who you want to be with you in labor, you probably do not want strangers and unnecessary visitors. Consider ways your birth place has to keep your labor private. Are there doors you need to keep closed, window coverings that need to be attended to. Do you feel comfortable making noise, or do you feel the neighbors can hear you? Is there a way to secure adequate privacy?

Fresh Air

Many women enjoy the feeling of breathing fresh air during labor. Does your labor place have a garden in which you can walk, or windows that can be opened? Are there places you can stop to get fresh air earlier in your labor, before you move to your birth place? In the absence of fresh air, do you have access to a fan to create a gentle breeze and prevent the air from feeling stale?

Aroma

Women in labor are more sensitive to smells than they usually are. Does your birth place have a smell you enjoy, or one that is uncomfortable for you? Can you use aromatherapy to improve the scent, or should you remove some items to change the aroma.

Temperature

A comfortable temperature may be warm enough for the mother to be undressed, or slightly cooler if she experiences a lot of body heat. Temperature can be one of the most difficult aspects to control because what is comfortable will probably change during labor. Does your birth place give you the ability to adjust the temperature? As a woman progresses in labor, her body will go through hot and cold flashes which can be uncomfortable. It is impossible to change the entire environment of the birth place quick enough to meet these needs. In these cases you may want to have available warm blankets, wash cloths that can be moistened with either cool or warm water, and thin sheets to provide a modesty cover in the mother overheats but does not want to be completely uncovered.

Getting the Environment You Want

If you are giving birth at home, you will be in total control of the environment. If you are giving birth in a hospital you may need to get creative to achieve a relaxing environment.

List only the most important points

Do not feel you have to give your opinion about every environmental factor. Instead, choose the one or two issues that will make the biggest difference to your ability to relax and be comfortable.

Ask for assistance

By asking the nurse for assistance you can gain from her experience with other couples. She may have suggestions for ways to achieve the environment you desire.

Quietly enforce your decisions

If the nurse leaves the door ajar every time she leaves the room, have a support person close it. If she leaves lights on, shut them off. The nurse probably does not mean anything personal by it, and you do not need to make a big scene or argue the point. As long as you have already made sure it was safe, do it.

Risks of Labor Environment

Most things done to alter the environment are safe for labor. However, being aware of your surroundings is important for injury prevention at any time. For example, water splashed on the floor could cause someone to slip, dark rooms may increase risk of running into furniture, and candles have the potential to cause burns. Use common sense to minimize any risk.