Plan for an ideal natural birth in the maternity hospital. How to make a plan for childbirth and what to do with it then

For the first time, I came across a real application of the Birth Plan in Finland, in a perinatal center in the city of Pori. We went there with colleagues to train and exchange experiences in the obstetrics system.
A Finnish midwife told us about the many non-pharmacological methods of pain relief they use during childbirth. For example, they give subcutaneous injections of saline around the Michaelis diamond, which causes a burning sensation, but it is this effect that helps reduce back pain. They also use needles (in Austria, too, acupuncture goes with a bang) or a Darsonval-type device, which the woman herself controls during labor.
Of course, medical methods of pain relief are also used - epidural anesthesia or laughing gas. Then I was worried about the question - how do they make a choice, what to offer a woman? To which the midwife, raising her eyebrows in surprise, replied - "We are following the Plan for the birth of a woman!"
A birth plan is a mandatory paper with which women go to a meeting with a doctor. They discuss and fill it out together, and this plan is pasted into the birth history! It is from the Birth Plan that the doctor and midwife learn about the mother's preferences regarding positions in the second stage of labor or pain relief, as well as about feeding and caring for the baby.
I raised this topic not by chance. Now many women come to me with the text on the A4 sheet - the Birth Plan, which they made without a doctor and a midwife. Some bring just a list of their wishes and preferences. Others make very rigid plans, with references to laws, and something, in my opinion, similar to an order. Because the plan does not contain the words “I would like, I plan to ...”, there are more often “I don’t want”, “I demand”.
At one time, I happened to draw up a sample birth plan. One of my listeners was preparing for childbirth with me, and she went to the USA to give birth, and her doctor asked her about the birth plan when we met. She first heard about it and wrote to me asking me to send her a sample. In Russian practice, such a document is not used, it was necessary to raise foreign literature on preparing for childbirth.
Of course, the English-language birth plans have specifics, which I adapted a little to our realities and, as an option, made a universal birth plan, which can be changed at your discretion:

What is important when drawing up a Birth Plan?

Discuss it with your doctor.
A plan is a blueprint, the actual situation may be different and you need to be flexible on many points in your birth plan.

Use "I'd like" and "I'm planning" instead of "I don't" and "I don't want to."
Provide items in the birth plan about urgent and emergency situations in childbirth.
Introduce your plan to your partner, midwife, doula.
Pay special attention to the moments that are important to you in childbirth.

It is better to build a birth plan chronologically, starting with the first stage of childbirth, then the second, third and most recent points to cover the postpartum period. Wishes for child care, vaccination and breastfeeding issues can also be highlighted separately.

What does the Birth Plan give your doctor?

For the doctor who will conduct the birth, these are reference points that you can immediately pay attention to and discuss without wasting time. It is difficult to guess what will be the key for this patient in her satisfaction with her own childbirth, and having a birth plan, the doctor has a guideline that needs to be discussed with you first and dot the i's.
The doctor will be able to understand your expectations and ideas about the birth process, evaluate your preparation. Often we come to the doctor with a very vague idea of what can be implemented in a maternity hospital and what can not. Our knowledge about medical manipulations, their necessity, benefits and harms is also very superficial. When discussing the birth plan, the obstetrician-gynecologist and midwife will answer all questions, which will help to establish a constructive and trusting relationship at the very beginning of the journey.

What does the Birth Plan give us?

1. For ourselves, we structure expectations from the upcoming birth and wishes for the process.
2. We will know exactly what needs to be discussed when meeting with an obstetrician-gynecologist.
3. Immediately after the doctor's appointment, you will understand what is realistic from our wishes, and what should be completely excluded from the Plan and trust the specialists.
When planning a birth, we can rethink where we are willing to be flexible, and where it is best not to. In this case, you need to answer yourself the question - what will happen to me if this does not happen? If it will not be possible to wait for the end of the pulsation of the umbilical cord due to the need for resuscitation for the baby? The birth plan is a good opportunity for an open dialogue with the doctor and midwife of your choice. By getting answers and discussing each point, you will better understand each other in advance, which is very important for a trusting relationship.

Who can help make a Birth Plan?

If you find it difficult to write a Birth Plan yourself, you can do it together with your doctor, midwife, specialist for whom you prepared for childbirth, or write it together with a doula.
If you are confident in your abilities - the Birth Plan template will help you!

Have you used the Birth Plan? How were they made? On your own or with someone else's help? Write to me!

Victoria Chebotareva

PREGNANCY PLAN

1) prevention of fetal RDS (2 doses of betamethasone IM 12 mg every 24 hours or 4 doses dexamethasone IM 6 mg every 12 hours; or 3 doses dexamethasone IM 8 mg every 8 hours)

2) prevention and treatment of chronic infection;

3) dynamics of blood pressure, p / a blood to detect preeclampsia;

4) prevention of premature birth;

5) delivery with an increase in signs of intrauterine suffering of the fetus.

DELIVERY PLAN

I period - cervical opening

1. In the prenatal room, clarify the history, conduct an additional examination, a detailed examination of the woman in labor, including external obstetric studies.

2. Carefully monitor the condition of the woman in labor in the maternity ward. Find out the state of health, the condition of the skin, listen to the heart sounds of the fetus, calculate the heart rate. measure blood pressure, pulse.

3. Childbirth lead through natural ways.

4. Controlled. HELL.

5. Observe the nature of labor, monitor the frequency, duration, strength and pain of contractions

6. Monitor the condition of the fetus, listening to the fetal heart sounds by auscultation every 15-20 minutes, with the outflow of amniotic fluid every 10 minutes. With a heart rate of less than 110 and more than 106 - control of CTG.

7. Monitor the emptying of the intestines and bladder every 2 hours.

8. Careful toilet of the external genitalia after each urination and defecation.

9. Reception of easily digestible food.

10. With an increased level of blood pressure above 160 mm Hg. perform an amniotomy.

11. With the weakening of labor activity - labor intensification with oxytocin.

12. If there are signs of heart failure - caesarean section.

II period - expulsion of the fetus

1. Monitor the general condition of the woman in labor.

2. Observe the nature of labor, monitor the frequency, duration, strength and pain of contractions.

3. Conducting an obstetric examination in order to determine the progress of the presenting part of the fetus along the birth canal.

4. Monitor the condition of the fetus (heart rate after each attempt)

5. Observation of the condition of the external genital organs and the nature of the discharge from the vagina

6. Stretch control

7. Reducing tension in the perineum.

8. Monitor the correct course of childbirth.

9. Control the biomechanism of labor in the posterior occipital presentation:

The first moment is the flexion of the fetal head. In the posterior view of the occipital presentation, the sagittal suture is set synclitically in one of the oblique dimensions of the pelvis, in the left (first position) or in the right (second position), and the small fontanelle is turned to the left and posteriorly, to the sacrum (first position) or to the right and posteriorly, to sacrum (second position). The bending of the head occurs in such a way that it passes through the plane of entry and the wide part of the cavity of the small pelvis with its average oblique size (10.5 cm). The leading point is the point on the swept seam, located closer to the large fontanel.

The second point is an internal incorrect turn of the head. An arrow-shaped seam of oblique or transverse dimensions makes a turn of 45 ° or 90 °, so that the small fontanel is behind the sacrum, and the large fontanel is in front of the bosom. Internal rotation occurs when passing through the plane of the narrow part of the small pelvis and ends in the plane of the exit of the small pelvis, when the sagittal suture is set in a straight size.

The third moment is further (maximum) flexion of the head. When the head approaches the border of the scalp of the forehead (point of fixation) under the lower edge of the pubic articulation, it is fixed, and the head makes further maximum flexion, as a result of which its occiput is born to the suboccipital fossa.

The fourth moment is the extension of the head. A fulcrum (anterior surface of the coccyx) and a fixation point (suboccipital fossa) were formed. Under the influence of generic forces, the head of the fetus makes an extension, and from under the womb appears first the forehead, and then the face facing the bosom. In the future, the biomechanism of childbirth occurs in the same way as in the anterior form of the occipital presentation.

The fifth moment is the external rotation of the head, the internal rotation of the shoulders. Due to the fact that the biomechanism of labor in the posterior occipital presentation includes an additional and very difficult moment - the maximum flexion of the head - the period of exile is delayed. This requires additional work of the muscles of the uterus and abdominals. The soft tissues of the pelvic floor and perineum are subject to severe stretching and are often injured. Prolonged labor and increased pressure from the birth canal, which the head experiences at its maximum flexion, often lead to fetal asphyxia, mainly due to disturbed cerebral circulation.

10. Provide obstetric assistance during childbirth:

Obstetric benefit in childbirth is as follows:

1. Adjusting the advance of the plunge head. To this end, while cutting the head, standing to the right of the woman in labor, place the left hand on the pubis of the woman in labor, gently press the end phalanges of four fingers on the head, bending it towards the perineum and restraining its rapid birth.

The right hand is positioned so that the palm is in the perineum below the posterior commissure, and the thumb and four other fingers are located on the sides of the Boulevard Ring (thumb on the right labia majora, four on the left labia majora). In the pauses between attempts, the so-called tissue loan is carried out: the tissue of the clitoris and labia minora, i.e., the less stretched tissues of the Boulevard Ring, is lowered towards the perineum, which is subjected to the greatest stress during the eruption of the head.

2. Removing the head. After the birth of the occiput, the head with the region of the suboccipital fossa (fixation point) fits under the lower edge of the pubic articulation. From this time on, the woman in labor is prohibited from pushing and the head is brought out of the attempt, thereby reducing the risk of perineal injury. The woman in labor is offered to put her hands on her chest and breathe deeply, rhythmic breathing helps to overcome the attempt.

The right hand continues to hold the perineum, and the left one grabs the head of the fetus and gradually, gently unbending it, removes it from the head of the perineal tissue. Thus, the forehead, face and chin of the fetus are gradually born. The born head is turned with its face backwards, the back of the head forwards, towards the bosom. If, after the birth of the head, an entanglement of the umbilical cord is found, it is carefully pulled up and removed from the neck through the head. If the umbilical cord cannot be removed, it is crossed between the Kocher clamps.

3. Release of the shoulder girdle. After the birth of the head, the shoulder girdle and the entire fetus are born within 1-2 attempts. During an attempt, there is an internal rotation of the shoulders and an external rotation of the head. The shoulders from the transverse pass into the direct size of the exit of the pelvis, while the head turns with its face to the right or left thigh of the mother, opposite to the position of the fetus.

When the shoulders are cut, the risk of injury to the perineum is almost the same as at the birth of the head, so it is necessary to carefully protect the perineum at the time of the birth of the shoulders.

When cutting through the shoulders, the following assistance is provided: the front shoulder fits under the lower edge of the pubic articulation and becomes a fulcrum; after that, the perineal tissues are carefully removed from the back shoulder.

4. Removal of the body. After the birth of the shoulder girdle, both hands carefully grab the fetal chest, inserting the index fingers of both hands into the armpits, and lift the fetal body anteriorly. As a result, the trunk and legs of the fetus are born without difficulty. The born child is placed on a sterile heated diaper, the woman in labor is given a horizontal position.

11. After birth, the baby is placed on the mother's stomach and injected with 1 ml of oxytocin IM

12. Observe sterility for the prevention of purulent-septic complications.

13. Prepare a table for the newborn, notify the neonatologist, renimatologist about the birth of a child

14. Prepare the ventilator, electric pump, catheters

15. Make the first toilet of a newborn

16. Assess the condition of the newborn on the Apgar scale

17. Assessment of blood loss during childbirth.

III period - consecutive

1. Actively wait and see

2. Observation of the condition of the woman in labor

3. Definition of WHDM

4. Bladder catheterization

5. Assessment of acceptable blood loss

6. Signs of separation of the placenta:

Schroeder's sign: immediately after the birth of the fetus, the uterus is rounded and its fundus is at the level of the umbilicus. If the placenta has separated and descended into the lower segment, the fundus of the uterus rises up and is located above and to the right of the navel, and the uterus takes on an hourglass shape.

Alfeld's sign: the ligature applied to the umbilical cord at the genital slit of the woman in labor with the separated placenta falls 8-10 cm and below the vulvar ring.

Sign of Dovzhenko: a woman in labor is offered to breathe deeply: if the umbilical cord does not retract into the vagina during inhalation, then the placenta has separated.

Sign of Klein: the woman in labor is offered to push, with the placenta separated, the umbilical cord remains in place, but if the placenta has not yet separated, then the umbilical cord is pulled into the vagina after an attempt.

Sign of Chukapov-Kustner: when pressing the edge of the hand on the suprapubic region, with the separated placenta, the uterus rises, the umbilical cord does not retract into the vagina, but rather comes out even more.

Sign of Mikulich-Raditsky: after the detachment of the planet, the placenta may descend into the vagina, and the woman in labor may feel the urge to push.

Sign of Hohenbichler: with an unseparated placenta during uterine contraction, hanging from the genital slit, the umbilical cord can bleed

With positive signs of separation of the placenta, the placenta is allocated independently.

The biomechanism of placental separation: after the birth of the fetus and the discharge of the posterior amniotic fluid, the volume of the uterus is greatly reduced and at the same time the inner surface of the uterus is sharply reduced. As a result, a spatial mismatch (displacement) of the areas of the uterus and placenta is created, since the tissues of the latter do not have the contraction property inherent in muscle tissue.

When these ratios change, “folds” appear on the inner surface of the uterus at the location of the placenta, which gives rise to detachment of the placental tissue. At the same time, intrauterine pressure also decreases sharply. This leads to the fact that the placenta gradually separates from the wall of the uterus, and then completely leaves its cavity to the outside.

Detachment of the placenta is accompanied by a change in the contours (shape and height of standing) of the uterus. The fundus of the uterus, which was at the level of the umbilicus after the expulsion of the fetus, rises higher after placental abruption with simultaneous narrowing of the diameter of the uterus and the formation of a soft elevation above the symphysis (K. Schroeder's sign), while the uterus changes from a spherical shape to an ovoid one, its contours become clearer, and consistency is thicker.

Further, in the process of blood coagulation, which occurs in the placenta, which ceases to secrete the corpus luteum hormone into the uterus and thereby exert a selective relaxing effect on the placental area of the uterus. The own weight of the separated placenta, which pulls it down (outward); as a result of the "sagging" of the placenta, irritation of the receptor apparatus of the uterus will inevitably increase; the resulting retroplacental hematoma in most cases is a consequence of the onset of placental abruption, and not its cause.

7. The afterbirth is examined: size, color, degenerative, changes, inspection of the umbilical cord for narrowing, true nodes, size.

8. Inspection of the birth canal in the mirrors, suturing gaps.

period - early postpartum period.

1. Observe within 2 hours after childbirth for the general condition of the puerperal

2. Observe the newborn

3. Calculation of total blood loss

4. Identification and elimination of possible complications in the postpartum period.

5. Strict observance of sanitary and epidemiological requirements and rules of personal hygiene.

clinical course of childbirth.

Received multiparous in attempts, regular contractions from 01:00. The bright amniotic fluid poured out at 01:55.

Satisfactory condition, BP 120/70 mm Hg in both arms. For 10 minutes - 4 contractions of 35 seconds of a straining nature. The position of the fetus is longitudinal, the head is present, it cuts. Fetal heartbeat 128-132 beats/min., clear. Amniotic fluid is light.

02:05 A live full-term hypotrophic girl was born, Apgar score 8-9 points.

Within 1 minute after birth, with the consent of the woman, 10 units of oxetocin were administered intramuscularly.

After controlled traction of the umbilical cord at 02:10, the placenta detached itself and stood out: without pathologies, dimensions 16x15x2 cm. All membranes. The uterus contracted, dense, moderate bloody discharge. The birth canal is intact. Satisfactory condition, blood pressure - 110470 mm Hg. Art., pulse 84 beats / min. The uterus is dense. Blood loss 250 ml.

The primary toilet of the newborn was carried out:

1. After the baby's head passes through the birth canal, the baby is sucked amniotic fluid from the mouth and nasopharynx using a special device or a rubber bulb.

2. After that, they begin to process and bandage his umbilical cord. As soon as the baby is born, two Kocher clamps are placed on his umbilical cord, between which, after preliminary treatment with alcohol or iodine, it is cut with scissors. After that, the Rogovin staple is applied and the umbilical cord is cut off. Then the umbilical wound is treated with a weak solution of potassium permanganate, after which a sterile bandage is applied to it.

3. Treat the baby's skin, remove mucus and original lubricant from it with a special cloth soaked in vegetable oil. Inguinal, elbow and knee folds must be powdered with xeroform.

4. Prevention of gonoblenorrhea. To do this, the baby is placed behind the lower eyelid 1% tetracycline ointment.

5. At the end of the primary toilet procedure, they proceed to anthropometry: measuring the weight, height and circumference of the newborn.

postpartum period.

02:15 Condition is satisfactory. BP 100/60 mm Hg, pulse 78 beats/min. The uterus is dense, the bottom is 2 cm below the navel. Allocations are bloody, moderate.

02:30 Condition is satisfactory. BP 100/60 mm Hg, pulse 78 beats/min. The uterus is dense, the bottom is 2 cm below the navel. Allocations are bloody, moderate.

02:45 The condition is satisfactory. BP 100/60 mm Hg, pulse 78 beats/min. The uterus is dense, the bottom is 2 cm below the navel. Allocations are bloody, moderate.

03:00 Condition is satisfactory. BP 100/60 mm Hg, pulse 78 beats/min. The uterus is dense, the bottom is 2 cm below the navel. Allocations are bloody, moderate.

04:00 Condition is satisfactory. BP 100/60 mm Hg, pulse 78 beats/min. The uterus is dense, the bottom is 2 cm below the navel. Allocations are bloody, moderate.

In the books of American and European authors about preparing for childbirth, the phrase "birth plan" is quite common. Childbirth, according to most experts, is an uncontrolled process, not entirely predictable. What kind of plan can we talk about?
It turns out that the birth plan is a list of wishes, preferences of the woman in labor. Writing a birth plan is a good way to figure out for yourself what is really important to you in childbirth. When you choose a hospital or doctor, the points in the plan will become questions for you to ask. The answers to these questions will help you make a decision.

I cite as an example the birth plan that one of the members of the naturalbirth community wrote for herself (with the permission of the author) (http://community.livejournal.com/naturalbirth/950878.html) in Russian translation.

"Nicole's birth plan.
I would prefer natural childbirth: without stimulation and anesthesia.

My husband, my mother and my doula will be present at the birth.

I want to be able to go home if dilation is less than 5 cm.

I would like to be able to dim the lights, listen to the music I brought with me, I need a calm atmosphere in the roadblock, no unnecessary equipment, no excessive staff, the opportunity to stay only with close people, if there is a desire.

As long as the condition of the child in childbirth is satisfactory, we do not want to be rushed or put a time limit on us.

I would like to be able to drink at will and eat light and high-calorie foods if the labor drags on.

Please do not offer pain relief.

I prefer CTG from time to time (rather than constantly), natural methods of inducing labor instead of oxytocin, if the need arises, do not want a puncture of the bladder, examination in labor only when necessary; If an intravenous infusion is needed, please place an intravenous catheter. Freedom of movement during childbirth is very important to me.

I want to give birth in the position that is most comfortable for me.I

I want to be able to touch the baby's head while pushing. I prefer to go through the glans eruption slowly, under control (meaning - the control of the staff. K.) to avoid breaks. To avoid an episiotomy, I would like protection and perineal massage. If an episiotomy is absolutely necessary, I want to participate in the decision. My husband would like to cut the umbilical cord. I would like to give birth to the placenta naturally: holding the baby on my stomach, with the umbilical cord cut after the end of the pulsation; if the placenta does not come out for a long time, I would like to try to give birth to her on his haunches.

If the baby is ok, I would like to have it immediately placed on my stomach. Please dim the lights. I would like to put the baby to the breast right away. I wish that the time of the first meeting of our family was private - no staff. I

I would like the examination and initial treatment of the newborn to be postponed until the first attachment to the breast, the medical examination in my presence, I bathe my child myself.
Only GV: no supplementary feeding and supplementation, please do not give pacifiers. We don't want circumcision. We don't want disposable diapers, we will provide cloth diapers.

Parents refuse to be vaccinated against hepatitis B in the maternity hospital. (Note - BCG is not made in the US)."

Many thanks to Nicole, easy delivery to her and fulfillment of plans!

Here is such a plan. I hope it will give you a reason to think, what would you like for your childbirth? And express your desires.

Because if you do not have your own birth plan, you will have to act according to the plan of the doctors - they have had it for a long time. But not the fact that your desires will coincide.

*Preparation for childbirth - group and individual, childbirth support, consultations on breastfeeding. Moscow, near Moscow region - 8 916 815 65 38; 8 916 351 58 93.*

- important points that I have compiled to observe during the birth of our son and which can help you in drawing up your plan.

I dreamed and dreamed of natural childbirth. But when I was diagnosed with ICI and stitched on the cervix, I realized that there was no question of any kind of birth at home. At that time, we attended courses for pregnant women and they explained to us how important it is, not only for the pregnant woman herself, but also for her team, to have a clear Birth Plan. It is clear that childbirth is an unpredictable thing and one must be prepared for anything. Therefore, this plan is needed, where it will be clearly described what and how, if something happens.

These people should have an idea of what you want from your Clans. I'll give you an example. When I got stitches, the doctor who did it asked where I plan to give birth. I said that I want the most Natural Childbirth, to which he said that of course they can be here. Then I asked one question - how much time do you give before you cut the umbilical cord. The answer put everything in its place - "well, 2-3 minutes is enough." Therefore, it is very important to know in advance and make it clear to the doctor what you expect and want from your Childbirth.

I made a plan for a long time, based on my wishes. It was drawn up 2 months before the birth.

I printed it out in 5 copies and put it in a ready-made bag for the maternity hospital. Before that, of course, I gave it to my husband to read :)

So, here it is.

childbirth

1. I can move freely and walk around the room

I did not want to be tied to the bed and lie on my back during contractions and pushing. For me, as well as for the process itself, it is very important to be in motion.

2. There should be dim, dim lights in my room.

That is, natural light from the window during the day or, as in my case, candles at night.

3. My music inside the ward

This aspect was very important for me. At first I planned to listen to traditional Celtic music, but ended up with relaxing yoga music. We even bought a special column, but since everything was not planned, we forgot it at home. The music ended up playing from our midwife's iPad (it's great that she had one!).

4. Give birth in your clothes

I wanted as few associations with the hospital as possible, so it was important for me to give birth in my personal clothes. I was wearing a simple elastic bandeau dress. In the end, of course, I took it off.

5. Do not offer painkillers/epidurals

I wanted the most natural childbirth, so I considered only non-drug methods of pain relief. During childbirth, there comes a time when you begin to feel that you can not cope and many begin to require anesthesia. It is very important at this time to have a person next to you who can bring you to your senses.

6. Do not pierce the amniotic sac

That is, wait until it bursts itself. Piercing stimulates very strong and painful contractions - this is considered the stimulation of the birth process. In addition, sometimes babies are born "in a shirt" - that is, in a bubble. In my case, we went to the hospital because my bubble burst, so it was irrelevant.

7. Minimum gynecological examinations

Watching the disclosure every time the bubble has already burst at least can bring an infection, and it doesn’t carry any particular information. I was watched 4 times for the entire time of Childbirth.

8. Dropper only for medical reasons

I was against the installation of a catheter on my arm. Again, because I wanted to minimize the hospital mood. In the end, of course, I was given a catheter only because it was necessary for medical reasons - bleeding began.

9. Offer me food and water between contractions.

Yes, I ate and drank during Labor. And I think everyone should do it. It takes so much strength and energy to give birth to a baby. In general, all the fuss about the ban on food and drink came out of the fact that potentially surgery may be required. I drank red wine (with the doctor's permission) and water. I ate bananas, apples, cheese, dark chocolate.

10. Offer me new positions

In childbirth, there always comes a moment when you have to change positions in order to find the right one in which it seems to be easier for you. For example, I could not lie on my back at all. I was in unbearable pain. During the contractions, I walked, lay in the bath, sat on the delivery chair. During attempts hung on the handle from the bed. She gave birth in a delivery chair.

11. Massaging my lower back during contractions

It helped a lot with the pain. When the contraction came, I would first say “conflict” to my doula and she would start massaging my lower back. Then even words were no longer required. My husband also helped with the massage.

12. Lying in the bath during contractions

When the maternity activity was in full progress, I climbed into the bath. Warm water relaxes and helps ease contractions.

12. Use natural methods of stimulation if labor stops

Sometimes they stop. And I did not want to resume the birth process medically with the help of the synthetic hormone pitocin. Natural methods are nipple stimulation, walking, changing positions, and so on.

13. No Episiotomy

I am opposed to episio - or the incision of the perineum, which is practiced in almost all childbirth. And without any meaning. Many doctors say that this is necessary in order to prevent rupture. But even studies already say that natural tears heal much faster and more painlessly than incisions.

14. Physiological birth of the placenta

This means that the placenta should be born on its own, without the prescribed pitocin or tugging on the umbilical cord. The exception is not passing the placenta within 60 minutes or bleeding!

15. Natural relaxation techniques

This includes breathing, acupuncture, massage, rebozo, pressure. For example, it helped me a lot when they breathed each contraction together with me and massaged the lower back.

After childbirth

1. No Pitocin

This synthetic hormone, oxytocin, is often given immediately to prevent bleeding. I see no reason to do this without a strong medical indication. That is, if the birth was normal and physiological.

2. Immediate skin-to-skin contact

Put the baby on my stomach immediately after he is born. This is important not only from a psychological point of view, but also from a physiological one. Children should receive microflora from the skin of their mother (or father), and not from the hospital table. In addition, it stimulates the separation of the placenta! Well, the “plus” - it even helps children breathe, as they feel your breath and heartbeat.

3. Clamp the cord only after the birth of the placenta

Or at least give her a boost. The blood and oxygen is still supplied to the baby, so it is important to let him get enough of her. In our case, unfortunately, this did not work out because I started bleeding.

4. Husband cuts the umbilical cord

For me it was important from an emotional point of view.

5. Save the placenta for encapsulation

This requires a separate post. But the point is to dry the placenta, crush it and then use it. Yes, you understood correctly - there is a placenta. So do all the females in the animal kingdom. The placenta contains numerous hormones and bioactive substances. Its use improves the flow of milk, reduces the risk of developing postpartum depression, and gives more energy. Unfortunately we were unable to use this service as I had a partial dense placenta accreta. But next time, if possible, I will definitely use it!

6. Examine the baby on my chest

This is where he should be. And all manipulations (of course, if everything is fine) can be carried out on my chest. Or wait a few hours - for example, measuring weight and height. Emelya was examined and listened to on my chest, and only then measured height and weight.

7. Refusal of drops in the eyes

As a standard, many maternity hospitals still instill antibiotics in the eyes of children. This is done to prevent infections that can be transmitted to them from their mother. Everything is “clean” with me, so I did not see the point in completely unnecessary antibiotic therapy.

8. Refusal of vaccinations

We wrote a refusal of all vaccinations. To explain for a long time, I already wrote my point of view on this matter.

9. Do not bathe the baby

Babies are born covered with a special protective lubricant, which, in my opinion, is simply unnatural to wash off. In addition, with the use of any chemical agents. We did not bathe Emelya, but only wiped him.

10. Consultation of a specialist in breastfeeding

No matter how rich my theory of breastfeeding was, I still had no idea how to breastfeed. Therefore, a knowledgeable person who showed how to properly apply to the chest came in handy. But my husband helped me a lot. It was he who helped put Emelyan to the chest and insisted on trying new positions if Emelya refused to take the breast.

11. The baby is always with me or with dad

My birth ended in heavy bleeding where I lost 1.5 liters of blood. It is clear that I spent the first 12 hours in intensive care. At this time, our baby was with dad. It lay on his bare chest and "enriched" with his microflora. In addition, my husband brought Emelya to me for feeding until I was transferred to our joint ward. If this item was not in my plan, Emelyan would go to the nursery and lie there alone, which in my opinion is absolutely unnatural.

Just in case

1. Do not hasten/induce labor

Only if there is a real threat to my life or the life of the baby.

2. Explain any interference to me first and then give time to discuss it with your team

In my case, the moment came when the progress of labor activity stopped. The baby was premature (I gave birth at 35 weeks) and he didn’t lie as it should, so I couldn’t relax and the dilation was 8 cm, but at a contraction no more than 6. In the usual “full-term” case, I would have been given Pitocin, but since it was a premature birth - there were two ways out. Or a caesarean or try an epidural, which will help open up to 10 cm, and then give birth without her. When the doctor told me about it, I couldn't believe it. In my eyes, it was the ruin of my dream of natural childbirth. But my midwife and doula agreed with the epidural as a necessary part of my Labor and helped me understand and accept it. As a result, she helped me open up to 10 cm, and I already lived through the attempts with all the delights of the birth process!

Cesarean section

1. Only strictly for medical reasons

In case of threat to my life or the life of the baby.

2. "Soft" CS

In Russia, only relatively recently began to practice this type of operation. I will definitely write a separate post about it. "Soft" it is called for many reasons. Below are some of them:

Before the operation, insert a sterile bandage into the vagina and then wipe the baby’s mouth, face and body with this bandage in the first 2 minutes after birth (when it lies on my chest). This is necessary in order to give the baby the mother's microflora, which he is deprived of, since he did not pass through the birth canal.
My team (husband, doula and midwife) with me in the operating room
I want to see the birth of my baby (that is, do not put up a fence)
If possible, give the umbilical cord a pulse
Husband cuts the umbilical cord
Leave my one hand free so I can hold the baby
Immediately attach the baby to my chest, if not, then to my husband

All points were fulfilled in my situation. Because I knew what I wanted. Because I had a plan. And of course, because we gave birth under a contract with the “right” doctor in the “right” maternity hospital, who shared our views on natural childbirth. And most importantly, we gave birth with the “correct” midwife, not a hospital one, but our own, who taught courses with us. which we knew personally. And I know that I would give birth again exactly there, with the same people!

* I am now actively mastering Instagram, my thoughts are about pressing problems and not only on evgenia_happynatural

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