What to expect when you're expecting (107 page)

If you’re a take-charge kind of person, the thought of handing control of your labor and delivery over to the medical team can be a little unnerving. Of course you want the doctors, nurses, and midwives to take the best possible care of you and your baby. But you’d still like to call as many shots as possible (including whether or not you get those shots). And chances are you’ll be able to, especially if you prepare thoroughly for labor and delivery at your childbirth preparation exercises, become familiar with the birth process, and develop an open and productive rapport with your practitioner, if you haven’t already.
Setting up a birth plan (see
page 294
), specifying what you would like to happen and not happen during a normal labor and delivery, also increases your control.

But with that said and done and written down, it’s important to understand that you won’t necessarily be able to call all the shots during labor, no matter how well prepared you are and no matter what type of practitioner you are laboring with. The best-laid plans of obstetrical patients and their practitioners can give way to a variety of unforeseeable circumstances, and it makes sense to prepare for that possibility, too. For instance, you’d planned to go through labor completely unmedicated, but an extremely long and trying active phase has sapped you of your strength. Or you’d hoped for an epidural, but your labor’s going extremely quickly and the anesthesiologist doesn’t arrive in time. Learning when it’s necessary to relinquish the reins—and be flexible—is also in the best interest of you and your baby, and it is an important part of your childbirth education.

“I’ve always associated hospitals with sick people. How can I get more comfortable with the idea of giving birth in one?”

The labor and delivery floor is by far the happiest in the hospital. Still, if you don’t know what to expect, you can arrive not only with contractions, but with apprehension. That’s why the vast majority of hospitals and birthing centers encourage expectant couples to take advance tours of maternity facilities. Ask about such tours when you preregister, and look online, too. Some hospitals and birthing centers have websites that offer virtual tours. You can also stop in for an informal peek during visiting hours; even if the actual labor and delivery area is off-limits then, you’ll be able to view postpartum rooms and take a good look at the nursery. Besides making you feel more comfortable about the surroundings where you’ll be giving birth, this will give you the opportunity to check out what real newborns look like before you hold your own in your arms.

Chances are you’ll be happily surprised by what you see when you pay your visit. Facilities vary from hospital to hospital and from birthing center to birthing center, but as competition for obstetrical patients increases, the range of amenities and services offered in many areas has become more and more impressive—less hospital, more hotel. Comfy birthing rooms are the rule, rather than the exception, in more and more hospitals (they’ve always been common at birthing centers staffed by midwives).

Childbirth Education

The countdown is on—and baby’s just around the corner (give or take a few months). Of course you’re eagerly awaiting the arrival of your little one. But are you just as eager for the arrival of labor and delivery? Could that be trepidation (make that panic) mixed in with that excited anticipation?

Relax. It’s normal to be a little nervous about childbirth—or even a lot, especially if you’re a first timer. Just about every parent-to-be is. But fortunately, there’s a great way to ease jitters, to calm worries, and to feel less anxious and more confident when that first contraction strikes: by getting educated.

A little knowledge and a lot of preparation can go a long way in helping you feel more comfortable when you enter the birthing room. Reading all about childbirth can definitely give you an idea of what to expect (and you can start doing that on
page 380
), but a good childbirth education class can fill in even more blanks. So it’s back to school, Mama (and Papa).

What’s in a childbirth education class for you and your coach? That depends, of course, on the course you take, the instructor who teaches it, and on your attitudes (as was true back in your school days, the more you put in, the more you tend to get out of a childbirth education class). No matter what, there’s something in it for every soon-to-be-laboring team. Some potential benefits include:

A chance to spend time with other expectant couples who are at the same stage of pregnancy as you are—to share experiences and tips; compare progress; trade tales of woes, worries, aches, and pains; and swap notes on baby gear, nursery gear, pediatricians, and child care. In other words, lots of expectant camaraderie and empathy. It’s also a chance to make friends with other couples who, like you, will soon be parents (a definite plus if your current crowd of friends hasn’t taken the baby plunge yet). Keep in touch with these classmates after delivery and you’ve got yourself a ready-to-go parent’s group—and playgroup for the kids. Many classes hold “reunions” once everyone has delivered.

A chance for dad to join in. So much of pregnancy revolves around mom, which can sometimes leave an expectant father feeling like he’s on the outside looking in. Childbirth education classes are aimed at both parents and help to get dad feeling like the valued member of the baby team he is—particularly important if he hasn’t been able to attend all the prenatal visits. Classes will also get dad up to speed on labor and delivery so that he can be a more effective coach when those contractions start coming. Best of all, perhaps, he’ll be able to hang out with other guys who can relate—among other things, to those maternal mood swings he’s been on the receiving end of and to nagging feelings of daddy self-doubt. Some courses include a special session for fathers only, which gives them the chance to open up about concerns they might otherwise not feel comfortable expressing.

A chance to ask questions that come up between prenatal visits or that you don’t feel comfortable asking your practitioner (or that you never seem to have the time to ask in the context of a hurried visit).

A chance to learn all about it—labor and delivery, that is. Through lecture, discussion, models, and video, you’ll get an inside peek at what childbirth’s all about—from prelabor symptoms to crowning to cutting the cord. The more you know, the more comfortable you’ll feel when it’s actually happening to you.

A chance to learn all about your pain relief options, from Demerol to an epidural to a spinal—even to CAM approaches.

A chance to get hands-on instruction in breathing, relaxation, and other alternative approaches to pain relief and to get feedback from an expert as you learn. Mastering these coping
strategies—and coaching techniques—may help you be more relaxed during labor and delivery, while somewhat decreasing your perception of pain. They’ll also come in handy if you’re planning on signing up for an epidural or other pain meds.

A chance to become familiar with the medical interventions sometimes used during childbirth, including fetal monitoring, IVs, vacuum extraction, and C-sections. You may not encounter any of the available interventions during your labor—or only one or two—but knowing about them ahead of time will make labor a little less intimidating.