Sometimes couples either cannot afford a doula or childbirth class, or are too far into the pregnancy to find one. For that reason I have put together a list of what I consider to be the most important things to remember when having a baby.
- Do not get induced unless is it medically necessary. Inducing dramatically increases the risk for other interventions and cesarean sections, and makes for a much more difficult and long labor for mom and baby.
- It is wise to go to the hospital when the contractions have established a strong, active pattern. A good emotional sign post of active labor is when the mom has not been smiling or talking in between contractions for a few hours. The contraction pattern is usually about 2-3 minutes apart, each lasting for at least one minute, and that cycle lasting for at least one hour.
- When at the hospital, stay active by asking for intermittent fetal monitoring using the Doppler instead of Electric Fetal Monitoring (EFM). This allows you to walk around and move rather than being confined to the bed.
- If you plan on getting an epidural, try not to get it until dilation is at least 6 centimeters, and ask for the "walking epidural". This does not actually allow you to walk, but allows you to feel just enough to push more effectively. Pushing effectively reduces your chances of a c-section, vacuum or forceps delivery, and tearing.
- Push slowly. It is not a race. It is okay to tell the hospital staff if you prefer "mother directed pushing". When the baby begins to crown (also known as the "ring of fire") stop pushing and just blow until the baby is born. A slow delivery of the head and shoulders will significantly reduce chances of tearing, or eliminate it all together. Pushing on your side or hands and knees can also reduce the chances of tearing.
- Delay umbilical cord clamping. Once baby is born it is routine in hospitals to immediately clamp and cut the umbilical cord. Ask your care provider beforehand to delay clamping the cord until it is no longer thick and blue, but rather white and not pulsating (this only takes about 5 minutes). This allows more blood from the placenta (baby's own blood) to flow into baby, and reduces the chances of anemia and lethargy.
- Nurse your baby within an hour or so after birth, and keep baby in the room with you. Babies' sucking reflex is strongest soon after birth. This increases the baby's chance of a successful latch.
- Ask that the baby not receive a pacifier or bottle. This helps encourage a great nursing relationship from the start.
- If you eventually plan on pumping, wait at least 4 weeks until a good nursing relationship has been established and until the mother's nipples are no longer sore when nursing.