APPROACHING A BIRTH PLAN

Pregnancy is an exciting time for expectant parents, andchildbirth is a miraculous event. Nevertheless,

due to the innate unknowns, it can result in considerableanxiety and sense of loss of control.

One means of combating these feelings is throughthoughtful preparation of a birth plan based on realistic

and trustful communication among all the parties who willbe involved.

Since the early Roman period,pregnant women in labor had beenattended by friends, relatives, orothers experienced in aiding withchildbirth. As time progressed, themanagement of the laboringwoman became more involved andthe advancement of technologies tobetter monitor the unborn childand the mother required a change inthe birth place and the sophisticationof the caregivers.

In association with these changes came the option ofoperative delivery (cesarean section) which in2012 accounted for close to 30% of all births in theUnited States, according to the Centers for DiseaseControl and Prevention (CDC). Cesarean sections areknown to be medically indicated for a number ofreasons to safeguard the well being of baby and/ormother. At the same time, for most pregnancies thatare low risk, cesarean section may pose greater risksthan vaginal delivery, especially risks related tofuture pregnancies.

Due to the recent rapid increase in the cesarean sectionrate and concerns that operative delivery is overused

without clear evidence of improved maternal ornewborn outcomes, the American College of

Obstetricians and Gynecologists (ACOG) issued in 2014new recommendations targeted at preventing women

from having cesarean sections with their first birth andat decreasing the national cesarean rate.

Pain management is a significant component of thebirth plan. Although most mothers report only milddiscomfort during early labor, as contractions becomestronger, longer, and more frequent, painintensifies and may require relief with either spinal orepidural anesthesia. Although the medications aregenerally considered safe, very rare complications canoccur. For those women opting for a morenatural childbirth, the participation in a yoga programduring pregnancy or the use of hypnosis havebeen described.

Whatever birth plan is developed foran individual pregnancy, it should

always be tempered based onthe saying “the best laid plans of mice

and men often go awry”. Theoverriding goal should always be a

safe birth for both mother and baby. Ifcommunication and trust exist among

all parties, childbirth can be amagnificent process.