A new survey of California labor and delivery nurses was recently released by the Perinatal Advisory Council: Leadership, Advocacy, and Consultation revealing three distinct things that L&D nurses would like for pregnant women to do to better prepare for childbirth. 525 nurses were surveyed and 56% of them had 21 or more years of experience as a L&D nurse.
1. Almost all of the nurses surveyed felt all women should participate in childbirth education classes (94%).
Childbirth education does a lot to help women release the fears they have surrounding the birthing process. Taking a childbirth class can help familiarize you with what is normal in labor and delivery as well as the options for pain management available to you. In class, you will also discuss the various medical interventions that might be used or necessary and the risks and benefits of those interventions. I offer Lamaze based classes for women in Letcher, Knott, and Perry counties and will travel farther out to provide classes as needed. One of the nurses surveyed stated, “Women think that watching The Baby Story and similar shows on TLC, etc., is preparation for childbirth, and is realistic. This is not the typical birth experience.” Those programs are edited versions of birth stories made to be interesting for television. We also hear so many variations on the birth story, many of which are dramatic if not scary. It is a great benefit to a pregnant women to take a class from a trained educator to help her sort through the information available to her and the stories she will undeniably hear. I recommend taking any classes offered by the facility or practice where you will give birth, as well as a course given by an independent educator who is trained by any of the prominent childbirth education organizations in the country, such as Lamaze, Bradley, CAPPA, ICEA, Hypnobabies, or Birthing From Within. This way, you will have information particular to your care provider and birthing facility along with information about the various options available to you in birthing.
2. 79.8% believe a woman should prepare a birth plan.
This is something you will complete during a childbirth education course or during prenatal visits with your doula. Birth plans are not set in stone, but they are what your ideal picture of birth will be. More than being a rigid plan for how your birth will go, a birth plan is a flexible document that helps you discuss your preferences for birth with your care provider. Any birth plan you create should be discussed with your care provider and a copy provided for them. It is also a good idea to have a few copies on hand for your support persons or doula, and labor and delivery nurses. It is highly important that after you picture your ideal birth experience that you also prepare for things to not go exactly as planned. When I say this, I don’t mean to fret and be fearful of the unknown, or to even expect things to go anyway but normally, but to familiarize yourself with medical interventions and when and why they are used. By preparing yourself in this way, the decision making process will be less of a fearful experience if any of those interventions become necessary. You can remain the primary decision maker through your birth process. Birth plans should be short, highlighting the major points of your care and that of your newborn baby. For example, if you choose to use pain meds, or if they become necessary, do you want an epidural or would you prefer trying a pain medication administered through your IV first. It is more like a map of the preferred path you would like your birth to take, and detours placed in the order that they are acceptable to you should the need for them arise. Birth plans should be able to be read quickly, and be respectful of the trained professionals attending your birth. For my clients, I use the birth plan available on Mother’s Advocate. It is simple, one page, with check boxes. Know too, that filling out a birth plan alone is not enough without educating yourself thoroughly about the decisions you are making in your birth plan. The best way to do this is through a childbirth education class.
3. More than half of the nurses welcomed women bringing along (the right) doula for their birth. (63.3%)
A doula is a trained, hired labor and birth partner who remains with the woman and her other support persons throughout labor, birth, and sometime through postpartum. Doulas offer phsyical, emotional, and informational support to the laboring mother. Labor and delivery nurses often have more than one patient they are responsible for and most times cannot be with the laboring mother during much of the experience. A doula is continuously with the mother, offering the non-medical support she needs. Doulas do provide clients with reliable information before the birth and as needed during the process, but they do not offer medical advice and do not replace medical professionals in a birth. One nurse surveyed said this about doulas, “Continual labor support from a confident and knowledgeable support person makes a huge difference in outcomes.” It has been shown that having a doula at your birth can reduce the time you spend in labor and result in fewer complications, reduces the need for medical interventions such as pitocin, forceps, and vaccum extraction, reduces negative feelings about the birth experience, and reduces the requests for pain medications such as epidural and the need for cesarean section.
Doulas can be certified through various certifying organizations, but do not have to be certified to practice. Trained doulas have completed a training program and have most often attended births before. The price of a doula varies, but most are willing to work on a sliding scale to ensure that women have access to the support they need during labor. I also offer doula services, and you can read more about those on my website.
This survey sheds light on the thoughts of those providing much of your care through labor and birth when choosing a hospital as your place of birth. Obstetricians and midwives working through hospitals generally do not have the time to spend with you during labor, and you will only see them as needed or as they are available in their schedule to be with you. L&D nurses most often have the bulk of the job of tending to your needs during labor. I found the survey enlightening to say the least, and I agree with every point made. Feel free to contact me with any questions you may have, or if you would like information on internet and book resources for more research and reading.
Many happy days to you and yours,