A Packet Publication 3B
The Week of Friday, March 31, 2017
HEALTH MATTERS
Dr. Benedict E. Asiegbu
Having choices can enhance birth experience
Where do you want to have your baby? Who will be with you during labor and delivery? Do you want an epidural or other pain medications? Expectant mothers have many choices when it comes to childbirth. And while there are seemingly endless factors to consider, research suggests that when women have choices about their labor and delivery and are involved in the decisionmaking process they are more satisfied with their birthing experience. At the Center for Maternal & Newborn Care at University Medical Center of Princeton (UMCP) women have a variety of options to support their childbirth experience and provide peace of mind throughout the delivery process.
Most women deliver their babies in a hospital, and most deliver vaginally. But whether you are expecting your first baby or preparing to welcome another child, childbirth is a different experience every time — one that is based on a variety of personal choices. Two of the biggest choices are who is going to deliver your baby and how are you going to manage pain? Some women prefer an obstetrician, while an increasing number are choosing certified nurse midwives to care for them during labor and delivery. Much of the role of a midwife is to support normal physiologic birth by avoiding medical interventions in healthy patients. High-risk patients
such as women with certain health conditions or who are expecting multiples, are typically cared for by obstetricians who are specially trained to handle complications. When it comes to pain management, the decision is highly individualized. In many cases, pain may be managed with techniques that support the natural process, such as water therapy, massage, movement and switching positions, and birthing balls. Medication is another option, and many women opt for an epidural, which can help relieve pain during labor, while still enabling them to stay awake and alert. Once an epidural is administered, however, it limits the ability to walk around and can slow the progression of labor. You will also need continuous monitoring of your baby’s heart rate. Certified nurse midwives are trained to administer epidurals. It’s important to note that even if you plan not to use medication during delivery, it is OK to change your mind during labor and
to request pain relief. Some other questions that you should consider as you plan to deliver your baby include: Who will be with you during labor and delivery? Your spouse or partner? Mother? Sister? Other friends or family members? Creating a supportive environment can help you have a positive experience. Do you prefer to be in a particular position during delivery? Traditionally, women were advised to lie on their backs during labor. Today, women have a range of choices and are often encouraged to walk around and sit up during labor. Does the facility where you will deliver promote skin-to-skin care? Skin-toskin care means that immediately after delivery your baby will be placed on your chest or abdomen. Skin-toskin helps babies maintain their own body temperature, increases restful sleep for babies, stimulates brain development, stabilizes heart rate and breathing patterns, increases a breast-feeding mother’s milk production, and improves parent/infant
bonding. Do you want to breastfeed? The choice of how you feed your baby is yours. Choosing to breastfeed can be a rewarding experience and the health benefits can be significant for you and your baby. Lactation counselors and consultants can offer support. What if you experience complications? The majority of births in the U.S. are normal deliveries, but, complications can arise. You should be confident that no matter what type of birth you choose that advanced care is available. Think about your options in advance of delivery and discuss your preferences with your care provider and whether your expectations can be met. While birthing plans are helpful, recognize that your plan may need adjusting once your baby is ready to enter the world. The Center for Maternal & Newborn Care at UMCP provides a supportive environment for labor, with nurses who provide education and birthing options and pain management to
support women throughout labor and delivery. Care is delivered by a team of family health specialists, including boardcertified obstetricians and gynecologists, nurses who are certified in neonatal and perinatal care, and certified nurse midwives. In addition, anesthesiologists are at the hospital 24/7 and maternal fetal medicine experts are available for women with highrisk pregnancies. Neonatologists from Children’s Hospital of Philadelphia are on-site to care for the newborns in the Neonatal Intensive Care Unit. To learn more, or to find an obstetrician/gynecologist or certified nurse midwife associated with Princeton HealthCare System, go to www.princetonbabies.com or call 888-742-7496. Benedict E. Asiegbu, M.D., F.A.A.P., is board certified in neonatal-perinatal medicine and pediatrics. He is a fellow of the American Academy of Pediatrics and the Medical Director of Neonatology at University Medical Center of Princeton.
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