In November, my husband and I began a birthing course led by the legendary Chiqui Brosas. The course, held in The Parenting Emporium every Sunday for 4-5 hours, is composed of three specific components, each designed to prep parents-to-be for the journey ahead:
- Day 1 is for an introduction to birth (the process, the experience, and the various options available for safe deliveries and their pros and cons), Common Complaints, Warning Signs, Advice on Healthy-Living while Pregnant (Nutrition), Basic Anatomy, Cardinal Movements, Pregnancy Exercises; on this day we also got a bonus pre-and-post-natal massage lesson as well as some Breast-Feeding 101 from a certified coach
- Day 2 is spent on Birth Plan, SOP’s on Hospital Procedures, Stages of Labor, Overview of Pain Management Options (and how they apply to your various delivery options too), Breathing & Relaxation Techniques, Birth Plan, Comfort Measures, Role of the Coach, Tests & Interventions; on this day you receive a special handbook that contains incredibly helpful, collated information for your birthing experience
- Day 3 is for a rehash on Day 1 and 2’s meatier bits (Stages of Labor, Meds & Drugs, Tests & Interventions, Post/Neo-Natal Care for Mother & Infant, Breathing & Relaxation Techniques, Pregnancy Exercises, Comfort Measures, Role of the Coach), as well as: Safe Sleeping for infants to prevent SIDS, Panic Routine, Positions in Labor, Massages, and Breathing; on this day you receive a big goody bag with freebies that will be useful to any mama in the post-natal period
It’s a lot to take in, but we found the entire experience incredibly helpful. Three of the things that have come most in handy so far are:
- Birth Plan Writing (how to write up a plan and agree on it with your doctor)
- Labor Room Bag & Hospital Bag (what to bring with you)
- Pregnancy & Labor Exercising & Positions (breathing, stretches, gentle exercise for aches and pains, kegels, “the proper way to push”, etc)
I’d like to do separate posts on most of these things, and so will start in this order.
In terms of writing a birth plan, I had seen many other resources (YouTube mamavlogs are also incredibly helpful), but I liked how straightforward Chiqui’s class was about it. In the green handbook she gave us, there was a one-pager sample birth plan that we could use as inspiration.
As such, it was easy for us to construct our own after we had gone over the different aspects of it in class and brought our questions and concerns to our doctor. I’m not an expert and haven’t even been able to test our own plan out yet, but I did learn a lot through the process of writing a Birth Plan, and think it’s a great way for mamas and papas to be to bond and better prepare for the big day ahead. After our own experience putting one together, I would have to say that these are the 9 most important things to think about (and some useful questions to ask yourself and your doctor):
- Type of Birth: What are the most important things to you for your birth given your own unique situation? Are you confirmed in either of the following birthing choices…:
- Environment & Comfort
- Private room? Or shared?
- Customized atmosphere?
- Option to put up a poster on the wall opposite your bed as your “focal point” while pushing?
- Scents? No scents?
- Who do you want/need in the room while giving birth?
- Who do you not want/need in the room while giving birth?
- Do you want to be able to eat throughout labor?
- Do you want to be mobile throughout the bulk of labor? (AKA: Want to be able to walk around?)
- Drugs, Meds, Procedures
- How do you feel about relaxation meds?
- Would you like a skin test done for allergies beforehand?
- Do you want an epidural?
- Do you want an IV put in from the start VS no IV at all? (Note that the IV is useful especially later on as labor can drag on and you will get to a point where you can no longer have food and drink but will need to stay hydrated and energized)
- Episiotomies: okay with having one VS don’t do one unless absolutely necessary VS just let it tear?
- Induction and/or drugs to help move labor along (ex. Petocin): yay or nay?
- Monitoring Throughout Labor
- Monitoring the baby:
- Hooked up all throughout VS regular checks to set a baseline every 2 hours or so
- Monitoring the mother:
- Hooked up all throughout VS regular checks to set a baseline every 2 hours or so
- Internal Exams — how frequent need they be, and would you prefer them done by a female nurse/doctor only?
- Monitoring the baby:
- Neo-Natal Procedures
- Does the father want to cut the umbilical cord?
- Do you want the Hepa and Vitamin K shots administered immediately?
- Do you plan to bank your cord blood?
- How long do you want them to delay cord cutting?
- Do you want to perform skin-to-skin for as long as possible immediately after birth?
- Do you want immediate latching?
- Hospital Stay Preferences
- Would you like for the baby to room in with you or would you prefer the baby sleep in the general nursery area? (Note: In some places, like now in Manila for example, the standard is to room in, and you can only request for the baby to stay in the nursery/neonatal care unit for one night — the first night, to allow the new mom some extra rest)
- Payment Methods
- Will you be arranging for insurance to pay for everything?
- Will you be pre-paying and asking for invoices for insurance reimbursement?
- Will you go completely non-cash (AKA: insurance handles everything)
- Additional Postpartum Procedures & Support
- Would you like a breast feeding consultant to come in and help you with latching and feeding in the 48-72 hours you are in the hospital?
- In some countries, you need to provide specific authorization for Newborn Screening Tests, so be sure to check with your doctor ahead of time on this
- If you are having a boy, will you have a circumcision performed on him or not?
- Do you want your baby to be exclusively breast fed?
- Do you refuse for your baby to be given even glucose solution with a cup? What are your limits and boundaries here?
- Would you like to bottle feed as soon as possible?
- Note: In some countries, they no longer allow bottles to even be brought into the hospital, so be sure to consult your doctor on this as well. (This is now true for the hospitals in Manila, for example.)
After asking ourselves and our doctor all of these questions, we were able to come up with our own plan. Here is what ours looks like: (note that names have been removed for privacy)
After careful consideration and consult with our doctor as well as our birthing instructor we have formulated the following birth plan for our own delivery. We are hoping for a normal delivery, with minimal medication outside of an epidural and standard IV, and we are glad that Hospital X, our doctor and her team of nurses and anesthesiologists, are well equipped to execute this plan with us.
The key features of our plan are as follows:
1. We would prefer a slightly personalized atmosphere. (We will bring our own pillows, labor bag with clothing, toiletries, food, drink, ice chips, music and personal speakers, etc. We may also want to put up a focus image on the wall for when it comes to pushing time.) Husband will also be in the room all throughout.
2. Before any meds can be ministered (to the mother), we would like a skin test done for allergic reactions.
3. We are open to having an IV splint put in early so that when the time comes we can have one inserted. However, we would like to remain mobile for as long as possible. (With the ability to walk around the room from time to time.) This means that external fetal monitoring while I am still mobile should happen in intervals as well.
4. Episiotomy only if necessary.
5. Light snacks (protein bars, dried/fresh fruits, nuts, biscuits, granola, and small sandwiches) allowed throughout labor up until the epidural goes in.
6. The epidural should be administered when dilated at 5cm. Upon reaching 9cm, we would like for the dosage to be lowered slightly so that when it is time to push at 10cm, I am able to feel the contractions and to engage actively in the pushing and delivery process. (Additional note: please do not administer any relaxation meds prior to the epidural. We are open to having the IV put in and to be “permanently” strapped in for fetal monitoring once the epidural takes effect. We understand that we will no longer be mobile at that point.)
7. We would like for all Internal Exams to be administered by female nurses/doctors only.
8. Upon birth, we would like:
— immediate skin-to-skin contact. Please allow at least 3 minutes for the umbilical cord to continue pumping as much nutrition for as long as we can.
— once cord is ready to be cut, the father would like to do so
— delaying of bathing/wiping/clothing baby first for prolonged skin-to-skin and immediate latching
9. Rooming in of baby.
10. Breast feeding coach support / consult for the days spent in the hospital.
11. All standard neonatal tests and inoculations to be given (including the Newborn Screening Test).
*Note: We also have with us a Guarantee letter from Insurance X and are in agreement that they will be in charge of directly liaising with the hospital over payment.
We will of course be flexible with all our points if any complications arise. We trust that you will inform us of any problems or changes to the plan as they surface so that we can actively participate in making the right choices or editing our plan.
This is a special moment in our lives, and we are very excited to be sharing it with our doctor and her team. We are confident in their expertise, and trust that, with God’s grace, we will be able to deliver safely and soundly.
Mother and Father’s Names & Signatures
Noted by: Doctor’s Name and Signature
Above all, the most important things about having a birth plan are the following:
- Allowing the birth plan to be a learning experience, and a framework with which to work off of
- But: continuing to keep an open mind about the birth itself. Anything can happen on the day and you and your doctor will need to be willing to do what is best for mother and child. So, while the birth plan is a great way to prepare and visualize the coming experience, it is useful to keep an open heart and mind to making last minute decisions if necessary. Many moms have told me that the birth plan doesn’t always turn out the way you had initially written it out to, but that it’s still a helpful exercise, and I trust them in that too.
I will likely provide another update postpartum on Birth Plan learnings, but for now that’s what I have to share.
ALSO: If you are a mama/papa-to-be and are interested in taking Chiqui’s class you can visit her sites here, and here.The good thing about her class is that, while she advocates for the Bradley Method and focuses on the perks of natural childbirth, she is also very practical about the types of choices women have to make (whether it’s to go for CS, or a medicated birth, or an all-natural one), so you never feel pressured or brainwashed to make one specific choice over the other. She came highly recommended by my doctor, and has been doing this for more than 25 years now. On top of that, her classes are great value for money, and I know this paragraph is starting to sound like an ad, but I do promise they are worth it! Especially if you are the type who likes to be prepared and plan for the future (both near and far).