It Is Your Right to Be Birth Informed

British Columbia. Canada.

On November 9, 2017, I found out that we were expecting our first little bean. While our journey to become parents has not been long, my career of choice has always been motherhood, ever since I was a little girl. While up until this point I have had minimal involvement in birth advocacy, I have taken it upon myself to spend the last few years educating myself in preparation.

The overwhelming sense of "Holy crap we did it," mixed with a smidgen of "Holy crap there's so much to do but so little time," can leave many expecting parents feeling lost and confused. It's like, "I don't even know what I don't know, or what I'm expected to know." But problem solved! Because in this article I will attempt to give you the 411 on all the baby mumbo jumbo you should know to get started!

1. You need a doctor. If you don't feel comfortable with your GP or family doctor dealing with your pre-natal care, or even ante-natal care, that's totally fine.

You have a multitude of options, but here are three to get you started:

1. Ask your doctor's office if they can refer you to an OBGYN, or if they are aware of any offices accepting pre-natal patients.
2. Take a visit to a walk-in clinic. When you see a doctor, ask them to recommend a doctor (if they are aware of any) who are accepting pre-natal patients. Sometimes doctors will take you on as a patient until you give birth, but there is the odd exception where the doctor will cover your pre-natal care and 6 weeks of postpartum care. Here's a pro-tip: I've spent the last six years trying to find a new doctor, it is tough and discouraging. Do not let your hopes be crushed! You will not be abandoned, just be patient... Just be a good patient ;) Ugh what a cliché, but it's true! Take heart, momma!!
3. I live in Northern British Columbia, so Northern Health is the medical institution which covers my area, and they helped me not only find a doctor who would take me on as a pre-natal patient, but they were incredibly supportive in supplying me with all the resources and information I could possibly want. While doctor's offices can seem daunting—trust me I've been to quite a few—they are generally over-stocked with pamphlets. Between you and your support system, be it S.O. or family, you can tackle every question you can possibly think of. Plus, you can never have too much information, you will never be too educated!

Education = being informed = making the best choices!

See, momma, it took a while, but now I am set.

2. Do you care about where you give birth? I do.

If you are anything like me, and are uncomfortable in a hospital, or simply don't want to give birth there, you have the option of giving birth at home. In British Columbia, midwives are covered under MSP (Medical Services Plan). If you plan to give birth at home, I highly recommend enlisting the help of a midwife; it is not mandatory, but many doulas will not work with an unassisted home birth.

My personal desire is to have a home birth. There are medical requirements to allow this, but assuming all goes well... I will have the blessing of delivering my baby surrounded by the people I love in my own home.

"OKAY WAIT, what is the difference between between a midwife and a doula?!" Great question! Even if you give birth in a hospital, you can still hire a midwife!

Why hire a midwife? A MIDWIFE is in charge of your health, baby's health, and nothing else. His or her primary focus is walking with momma through labour, birth, and (in B.C. for sure) six weeks of postpartum care. She takes vitals, administers medicine if necessary, and can provide medical intervention if it becomes required. A midwife is a nurse who specializes in birth! He or she is the all knowing, all caring entity who is in charge of bringing your baby Earth-side safely.

So if I have a midwife, why would I need a doula?! This is an excellent question many women may encounter. A midwife's primary concern is vitals vitals vitals. He or she will be keeping track of your progress, your dilation... with their attention completely focused on vitals and depending on your labour, they may not have time to give you all the Tender-Love-and-Care every mommy and daddy deserve. This is where a DOULA comes in.

A DOULA is your emotional support birth companion. For first-time mommas, birth can be a nerve-wracking. The unknown can cause anxiety, which is not good for momma, baby, or daddy! A doula will meet with you at least twice before your big day to discuss your birth wishes, answer your questions, and to help walk with you through the process. Doulas will also help you with writing a birth plan, which I highly suggest regardless of where you give birth. (We will talk about birth plans later on!) They will come to you whenever you feel that you need them. This means if you feel your first contraction and you want your doula there, call them! They will come to your aid. Or perhaps you're comfortable until your water breaks! It doesn't matter the time or the place: your doula will walk with you through whatever comes and wherever you are.

Doulas are also here to make daddy look good. They will say, "Hey daddy, maybe mommy would like a shoulder rub or glass of water or snack, etc." Parents could take 100 birth classes teaching about lamaze, breathing exercises, lactation/latching, and all the like, but when THAT moment arrives, your rehearsals tend to fly right out the window. A doula is trained in breathing exercises, pain management (not anesthetics), how to deal with contractions, how to encourage latching, breastfeeding tips, and some are even trained in spinning babies! (in case the baby is breech, which we will touch on later!) Your doula will accommodate you however you want to labour: at a hospital, at home, in the car, in the bath, in the shower, in the kitchen, in the back yard, in bed, standing up, laying down, upside down, whatever you desire! Don't worry, if this is your first baby, like mine, we may not have any idea what will be good for us, but that's okay because your doula will walk with you through all their knowledge until you find what works.

But what if I end up needing a c-section, or am planning to have a c-section to begin with?

Great question! A doula's purpose is to walk with you through birth, no matter how it happens. In the O.R. your doula will be verbally supportive, inform you of your options, explain what's going on, and support both mommy and daddy emotionally. Let's be real: birth is scary, but in an operating room? Talk about pressure and anxiety. Your doula will do her absolute best to calm you and support you. They really are like guiding angels.

3. What is your birth plan?

A birth plan is NOT written in stone. It is a written document your doula will be fully versed in on YOUR wishes as mother. It is wise to provide all your health care providers (i.e. GP, midwife, or the doctor delivering your baby) with a copy of this.

But what even goes on a birth plan?

Some things you can ponder while you're growing your miracle:

i) Delayed Cord Clamping: Delayed cord clamping has been proven to provide your baby with a boost of super juice! The blood inside your baby's umbilical cord is filled with powerful stem cells and bacteria which will give your baby a beautiful congratulatory birth gift! But if you don't want to delay, state that you would like immediate cord clamping! Many hospitals automatically provide delayed clamping, so if this is not appealing to you write it down!

ii) Immediate Skin-to-skin: Let's talk about those oxytocin vibes; skin-to-skin will rock your world. But here's the catch: when your baby is born it's not like the movies. Your baby will be covered in any number of fluids, which may seem disgusting to you. If you'd like your baby immediately, without being cleaned, write it down! Or if you wish for your baby to be cleaned up first, write it down.

iii) Who Is On Your Birthing Team: My birthing team consists of my husband, my mother, my doula, my midwife, and my mother-in-law. Remember this: birth is raw and vulnerable. Choose the people you invite wisely! You are under no obligation to allow them to stay either. Invite people who will understand if you need to say "GET OUT GET OUT NOW!" On the other hand, perhaps you want no one to visit you until the baby has been born? Or perhaps you don't want visitors in the hospital! This is great information to put on your birth plan, so your medical providers can do their best to accommodate.

iv) Choices on Pain Relief: i.e. epidural, nitrous gas, etc: State what kinds of pain relief you prefer, if any, and in what order. For example, you may prefer to try pethidine (demerol gas) before an epidural. You could mention breathing, relaxation, water, massage or a TENS machine as well as medical pain relief. And if there are any types of pain relief you wish to avoid using, make sure you write them down.

v) Your Preferences on Labour Positions

vi) Birth Pool or Other Birth Equipment: Balls, mats, pools, go crazy. If you want to try it, no matter how silly it sounds, do it! Unless your safety is compromised, you should give it a shot!

vii) Speeding up Birth: If your labour comes to a halt, or perhaps you're finding it to be too long, do you want your midwife or medical provider to use interventions to help things along, or would you prefer to let nature take its course?

viii) Assisted Birth Preferences: As we mentioned before, your baby could be breech. Baby being breech means baby is laying upside down! The odds are you will be aware of this prior to your labour, and your medical provider may give you exercises to try which may aid baby in turning. If this happens in my case, my doula is trained in spinning babies which is a manual way mommy and doula can move baby into proper birth formation. But if that doesn't happen, it is possible for baby to be born breech! In this case, your medical provider(s) will know exactly what to do. Don't worry, in most cases baby being born breech does not affect baby's health.

Breech Diagram

ix)Feeding Baby:Be clear: do you want to breastfeed or bottle-feed? Do you want a mix of both?

x) How to Handle Complications:If your baby has to go to the NICU, or to a special unit, do you wish to care for them yourself as much as possible, and be transferred with him to another hospital if a transfer is necessary? Or would you prefer your significant other to go with baby?

4. Your maternity benefits, what do you qualify for?

Lastly for today, you need to consider your maternity leave. Are you currently working full-time? Part-time? In British Columbia, starting December 2017, you are entitled to 18 months of maternity leave! What a huge blessing! According to the government of Canada, if you have worked 600 hours in the 52 weeks prior to the start date of your maternity leave, you qualify for maternity EI benefits! You should also take a look into your company policy, as employers are REQUIRED to extend modified duties to expecting mommas, be aware of what you are entitled to. Don't let any employer push you around! Find out what your medical insurance covers, it may be worth it to take up your benefits such as massage therapy or special services such as a midwife or doula. You don't know what's covered until you ask!

If you live in Canada, here is the link for this information.

It's a LOT to think about, but fear not! We can get through this together.

Until next time parental units,

Deidre,

First time momma!