Planning and Preparation

The Birth Room
"Women who can remain upright in the first stage of labor have less pain, so need fewer pain-relieving drugs, and dilate faster than those women who are lying down. Their babies' heart rates are also more likely to fall within the normal range.*
In the second stage, being upright also results in less pain, fewer drugs, easier pushing, fewer tears, more normal vaginal births, and a more positive birth experience.*" (p. 41)

"...sitting on a rigid chair or stool for a long time...develop swelling around your vulva, and the circulation of blood may be impeded...*" (p. 41 and 45)

A Birth Center
"A study of the experiences of 12,000 women who gave birth in 84 birth centers in the U.S. revealed that they had fewer obstetric interventions of all kinds than women in a hospital, while birth was equally safe.* In one English birth center, women have a 3 percent reduced risk of an emergency Cesarean compared with women giving birth in hospitals in the same area and are four times less likely to have an episiotomy.*" (p. 45)

"...care given by a midwife at home is safer than care from midwives in the hospital, and home birth with a midwife is safest of all.*" (p. 46)


Prenatal Care
Routine Tests--Anemia..."A pregnant woman has about 40 percent more blood flowing in her body...women whose hemoglobin concentration does fall are more likely to go to full term and to have babies of good birth weight. If hemoglobin concentration fails to fall, there is a marked increase in the incidence of low birth weight and preterm birth*...better able to absorb iron from food. If you drink orange juice instead of tea or coffee (both of which inhibit absorption of iron), your body will make good use of the iron that is naturally present in the food you eat.*" (p. 51)

Talking to Doctors
"...you may have to develop new social skills to create a satisfactory dialogue with those who care for you...The lack of continuity in care is one of the main criticisms that women make about childbirth in hospitals.*" (p. 53)

Preparing Your Questions
"There is no need to be apologetic about wanting further information or asking for help to achieve the kind of birth you would like." (p. 54)

"When a woman is feeling nervous, she tends to pitch her voice too high...You may also smile nervously without realizing it...giving the impression that you are content when you are not." (p. 54-55)

"It is a good idea to include requests that are not top priority, so that there is a possibility of compromise on some matters...Be assertive in a pleasant way." (p. 55)

"Make it clear that you are listening closely by 'playing back' the important statements: 'Do you mean...?' 'So you are saying that...?' and rephrase whatever has been said as accurately as you can." (p. 55)

"There is always a price to pay for being submissive. A woman avoids conflict, but afterward she is likely to feel that birth was something done to her, not something she did herself. Women who have suffered a sense of complete powerlessness in birth may go on feeling this long after the baby is born. It often leads to their feeling incompetent with the baby, too." (p. 56)

Choices
"Choice is eradicated when there is no continuity of care. Women speak and no one hears them...what they say gets passed on but is distorted...nurses are rushed off their feet trying to care for three or four patients in labor simultaneously...their [pregnant women] self-confidence is destroyed." (p.56)

What to Include in Your Birth Plan
"There is ample research now to show that a woman is most comfortable afterward when she has been helped to give birth gently without a cut or tear." (p. 59)