Rules in the Delivery Room

Rules in the Delivery Room The day you give birth to your baby is the next biggest day of your life! You've read and googled. You've freaked out only slightly, and you ask your friends, "What's labor like?" You ask your best friend, sister, and your doula "Are there rules in the delivery room?" Your doula explains that each hospital has policies and procedures and your provider has guidelines they'd prefer you to follow. She also explains informed consent and informed refusal, what those mean, and has encouraged talk about your concerns with your doctor. You have all the answers to your questions.

You're as ready as you'll ever be! The day arrives. You labor at home in bed in the early hours of the morning. Your doula supports you by phone a couple times during this early stage of labor. You've been managing contractions well, but as things pick up in intensity you decide it's time for your doula to come. A couple hours later you are ready to make your way to the hospital to delivery your baby. When you arrive to labor and delivery you have your birth preferences in hand.

Your preferences are as follows:

1. freedom of movement during labor

2. support & assistance from husband and doula at all times

3. labor peacefully

4. vaginal birth if at all possible

5. skin to skin Immediately after birth

6. delayed cord clamping

By this time you are quite tense from the commute over and triage. You're contemplating that epidural, but you worry you'll be judged.  Judged by family and friends who "warned" you it would be "too hard". Judged by your husband for being a wuss, and  judged by your doula who you specifically hired because you wanted to deliver non-medicated. Even worse, you're already judging yourself.

Everyone was in and out, checking machines, adjusting the monitors. If you didn't know better you would think the machines were doing all the "work" of labor. Your doula is solely focused on your needs. She is attentive, and reassuring. She is encouraging you and your husband to sway together beside the bed. Still to yourself you think, why me, why am I suffering?

Then, your husband makes a break for the door to update his mother. Your pacing the room with your doula and with the next contraction look into her eyes and something changes inside you. You are shivering, but not cold, you are quiet, but not at peace. She says, "Breath with me, like this", and she mimics the breaths for you and with you, she touches your shoulder as a cue to relax those muscles, and you remember what you learned in The Confident Birth & Parenting Class. With the next several contractions you continued this routine and kept your rhythm.

A couple more hours pass with great focus, many position changes, and comfort techniques being used. Before you know it you are 7 centimeters dilated. Excellent progress even with all measurements aside! The contractions are coming one on top of the other now and you are losing your rhythm. You've yelled a few times and you feel like you are about to lose the last of your chill. Your doula leans in close again and she says to you in between the next contractions, "What is it that you need? Tell me."

You reply with, "I don't know you tell me, that's why I hired you!" Your doula and husband remind you of your preferences, your "why"!  She tries to reassure you that your doing great and she will see you through this till the end. What comes next out of your mouth you never envisioned saying, "I give up, and I need drugs now!"

She assures you that you can't give up, because you have a baby being born. She reminds you that you are making incredible progress and that you are not giving up if you opt for pain medication. The tears begin to flow and your husband encourages you and tells you how strong you are. You're not convinced. How the hell could he, a man, ever understand this pain or having to make this choice?

"I really can't do this anymore, I want an epidural. Call the nurse." As requested your doula hits the call button and you let them know they are needed right away. Thirty minutes later they come to relieve your pain. It seemed to be the longest thirty minutes of the entire ordeal. While you wait through contraction after contraction your doula encourages you, helps you visualize, and reminds you of how far you have come.

It seemed that as soon as they had your epidural in place you were complete at ten centimeters and ready to push. This took you by complete surprise. This isn't what your friends said would happen. You've read it yourself, once you get the epidural the cascade of interventions happen and you were suppose to end up in the operating room having a cesarean, not pushing.

Just like that you're looking into your beautiful baby's eyes!

Fast forward a week. Your doula comes to your home to do a follow up visit with you and your husband. Part of what we do as a birth doulas is to talk through your experience with you, answer any questions you have, validate your feelings surrounding your birth, celebrate and commiserate along side you, and help you find resources you need. After some discussion of highs and lows through your labor and validating all those feelings you have; good, bad, and indifferent, your doula looks at you and says, "I am so proud of you both because no matter how he (your baby) was going to be born you did NOT give up!!" "Additionally, you labored without medication like you originally wanted and then you trusted yourself to know when you needed to navigate from the plan to get an epidural. Then, as I  recall it, and correct me if you don't feel this is your truth, but you continued to labor peacefully again until you were holding him in your arms, skin to skin. And you did end up giving birth vaginally. So I vote it a win! Congratulations to you both!"

Long story short, there are no hard fast rules in the delivery room about how you "should" give birth to your baby. With a really good birth class that teaches you about the process of labor and birth, your options, coping techniques, you can give birth and feel more relaxed and supported while doing it. Whether you stick to your "plan" or go completely off the beaten path to find what works for you, you can learn to trust your instincts, the process, handle the curve balls of childbirth! Happy Birth & Parenting! ~Elizabeth Luke