22 September 2011

Birth Resources: Home vs. Hospital and Pain Management

Deciding what you want out of your birth experience can be overwhelming. I wish that I had kept a list of the many resources I found while researching and preparing for my son's birth, because I did come across some very helpful sites.

One of the things that helped me realize all the options I had was getting my hands on a birth plan template. From there, I researched some of the things that I hadn't given much thought to, because they weren't things that I'd really thought about or realized I had an option of.

Homebirth vs. Hospital Birth
The first decision, if you're low risk and looking for a natural birth, may be whether to have a homebirth or a hospital birth. There have been several studies in the Netherlands that have attempted to ascertain the safety of a home birth when compared to a hospital birth.
Of the three studies below, the first two found that homebirth had no more or fewer complications than hospital deliveries. The third (and most recent), finds that care under a midwife (low risk pregnancies) had greater birth complications than did high risk pregnancies under the care of an obstetrician. Brittany at Birth Unplugged does a great job discussing study 2 and study 3 on her blog:
If you are giving homebirth some serious consideration, familiarize yourself with the laws in your state that might affect what type of care provider you may be able to hire. The Midwives Alliance of North America also has a state chart breaking down Direct-Entry Midwife Legal status.

If a homebirth isn't right for you, but feel that a hospital birth may provide unnecessary interventions, you might consider a Birth Center.

Whether you opt for homebirth, hospital birth, or a birth center, there are questions you'll want to ask about the place you expect to deliver and the type of care you'll receive. ICAN (the International Cesarean Awareness Network) talks about the different birth options and provides a fantastic list of questions that you may want to consider at the bottom of the page.

Pain Management
Probably one of the biggest decisions most women think about when planning their labor and delivery is what type of pain management they want. There are a number of options for women who want to use natural pain management techniques. Even if you don't plan on using pain medications, I strongly encourage you to research the different pros and cons of each type of pain medication, to ensure that you are as fully informed as possible about the risks and benefits of each prior to going into labor. A starting point for some of the benefits and risks of the different types of medications can be found in the Labor & Birth section of AmericanPregnancy.org, though I strongly encourage comparing information from several different locations (as well as talking to your prenatal care provider about them to determine if there are additional benefits or risks in your particular case).

Pain Medications
Note that this is not necessarily a comprehensive list of the options, but an overview of some of the common options available
  • Epidural
  • Spinal Block (note that this is different from the epidural)
  • Local Anesthetic
  • Narcotics
  • General Anesthesia (may be used in the event of Cesarean)
One thing you will want to consider is what option you may want to use in the event of a Cesarean. While discussing potential complications with my midwife during my own pregnancy, I was surprised to find out that if I opted for general anesthesia over epidural or spinal, that my husband would be unable to accompany me in the surgery, due to the extra space needed for staff and equipment for monitoring and administering the general anesthetic.

Natural Pain Relief
Again, this list is an overview, and not intended to be considered comprehensive
  • Counter Pressure
  • Breathing Techniques (ex: Lamaze)
  • Positioning with Birth Aids (ex: Birthing Ball, Squat Bar)
  • Setting up a calming/relaxing environment (ex: use of music)
  • Water
In addition to the above, there are programs such as Hypnobabies that some women swear by.

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