Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0044/00441.txt

Text File | 1993-06-14 | 14KB | 245 lines

$Unique_ID{PAR00441}
$Pretitle{}
$Title{Pregnancy:  The Third Trimester:  Planning and Preparation}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{Third Trimester Planning Preparation Hospital Out-of-Hospital Birth
home birthing center hospitals father labor delivery delivering medical
technological maternity newborn care complication complications birthing room
rooms LDR LDR's labor delivery recovery nursery nurseries Packing Suitcase}
$Log{
Most hospitals offer a variety of alternatives for childbirth*0054601.tif
A hospital delivery can be personalized to your family needs*0054701.tif
Having the father attend both labor and delivery has become the rule*0054801.tif
Home births have increased as parents try to make childbirth more personal*0055301.tif}

Miracle of Birth


The Third Trimester:  Planning and Preparation


Choosing Hospital or Out-of-Hospital Birth


     An important decision that you will need to make is where you will give
birth to your baby.  Most women choose to give birth in a hospital; others
decide to give birth at home or in a freestanding birthing center.  To make
this decision, you will need to investigate your options before your due
date draws near.
     You may find yourself facing conflicting opinions regarding the safety or
desirability of hospital versus out-of-hospital birth.  There are few general
rules; each pregnancy and each couple is unique.  Therefore, before you make
your decision, you need to make every effort to gather information on the
options available to you and the risks and benefits of each birth setting.
You also need to discuss with your doctor the specific circumstances and
requirements of your pregnancy.  Out-of-hospital birth is an option only for
the woman who is in good health, whose pregnancy is normal, and who did not
experience complications in any previous pregnancies.

Hospital Birth

     In the past, hospitals were generally inflexible in their rules regarding
childbirth.  A common complaint was that the birth process was treated as a
disease.  The family was often left out of the childbirth process; even the
father was not allowed to be with his partner during labor or delivery.  These
often demoralizing procedures led consumers to demand a more humanized
experience during labor and delivery.
     Starting in the early 1970s, hospitals began to reevaluate their policies
in response to these consumer demands.  Policies were changed to reflect an
awareness of the emotional aspects of labor and delivery and the effects of
childbirth on both parents.
     Today, most hospitals offer a variety of alternatives for childbirth.
Having the father attend both labor and delivery has become the rule rather
than the exception.  These changes have allowed parents-to-be to experience
childbirth in a more personalized way without having to give up the medical
and technological benefits of a hospital setting.
     If you prefer to give birth in a hospital, or if the circumstances of
your pregnancy require that you give birth in a hospital, your next decision
is which hospital to use.  If there is only one hospital in your area, your
choice is limited.  In most large towns and all large cities, there will be
several hospitals from which to choose.
     Not all hospitals offer the same types of maternity and newborn care.
Some hospitals (small, community-based hospitals, for example) can often
provide care only to women with essentially normal pregnancies who are
expected to deliver babies with no serious complications; they may not have
the equipment or staff to adequately cover complicated births.
     Other hospitals, especially those associated with large medical centers
or medical schools, specialize in the care of complicated pregnancies, in
which either the mother or the newborn will require more intensive care or
specialized facilities.  When deciding between these types of facilities, you
will need to take into account your own medical history, any history of
serious complications in previous pregnancies, and any complications in your
current pregnancy.
     Your doctor will have privileges to use at least one hospital; some
doctors use two or more.  It's a good idea to tour each hospital that your
doctor uses.  It may also be useful to tour other hospitals for comparison
purposes.  You may find that you prefer a hospital that your doctor does not
use.  If so, you may wish to change to another doctor who is on staff at that
hospital.
     If your community has more than one hospital, you might be surprised at
how different they are from one another in their facilities, policies, and
philosophies of care.  Most hospitals offer tours of their maternity
facilities and can usually schedule them at a time that is convenient for both
you and your partner.
     What do you look for when you tour a hospital?  First of all, simply
observe the atmosphere.  Take a look at what provisions are made for the
mother's comfort.  Many hospitals now have attractive private rooms and
bathroom facilities.  Some hospitals have very comfortable labor beds, while
others may have very narrow, hard labor beds.  Some provide nice touches, like
a rocking chair, a couch where your husband can rest, television and radio,
and beanbag cushions for getting into comfortable positions.  Others make few,
if any, provisions for the comfort of the mother or father.
     Many hospitals have now converted traditional labor rooms into "birthing
rooms" or LDR's (for labor, delivery, and recovery).  In these attractively
decorated rooms, the mother can labor, deliver, and recover without moving to
separate rooms.  In some hospitals, the birthing room is the only room that
the mother will be in throughout her entire hospital stay.  In others, she
labors and gives birth in the birthing room, and then goes to a regular
hospital room for one, two, or three days before going home.  In still other
facilities, she labors in one room, delivers in another room, goes to a third
room to recover, and then is moved to yet another room for the rest of her
hospital stay.
     While you are on the hospital tour, be sure to check the nursery.  What
does it look like?  Are the mothers encouraged to keep their babies with them
in their rooms, or do the babies spend most of their time in the nursery?
Does the nursery have cozy touches, like rocking chairs and wall decorations?
Do the nurses seem friendly and warm?
     What about the person leading the tour?  Is she friendly and willing to
answer your questions, or is she simply herding you through as quickly as
possible?  Unfortunately, some hospitals will be so busy that they will not
take you on a tour of the actual facilities but rather will present a slide
show or have you discuss policies and procedures with a member of the staff.
     Be sure to ask specific questions about the procedures of the hospital.
Where do you go when you are in labor?  Does your husband need to stop at an
admitting desk before he brings you to the maternity floor?  Can you
preregister now instead of rushing through it when you are in labor?  What
type of insurance forms should you bring?  Remember, it is a lot easier to ask
these questions now than it will be when you are in labor.
     Questions about hospital procedures and policies need to be asked
carefully.  For example, if you ask "What usually happens to the baby after
he or she is born?" you will probably learn more than if you ask "What is the
hospital's procedure for routine newborn care?"  Some hospitals may not have
specific policies, but they will have customs, and these are what you will
want to know.
     You might ask for a step-by-step description of what happens after a
woman in labor arrives.  Do most women have a nurse assigned to them, or do
the nurses take care of more than one laboring woman at a time?  Is it
customary for women to receive pain medications, or do most women use little
or no pain medication?  If a woman desires a natural or unmedicated
childbirth, is she actively encouraged and supported in this by the staff?
What types of pain medication and anesthesia are available?  Is there an
anesthesiologist (a doctor who specializes in administering anesthesia) in the
hospital at all times or is he called in only when needed?  Is a pediatrician
in the hospital at all times, or is he called in only when needed?  Do most
women receive intravenous fluids and continuous electronic fetal monitoring
(see Labor and Delivery)?  How long is the usual hospital stay?  You may want
to find out if there's a "short stay" program that allows mothers and babies
to go home within a few hours after birth.
     Finally, during your hospital tour, clarify the costs of labor and
delivery rooms, nursery charges, and so forth.  You might be surprised at
how hospitals, even those in the same town or area, may vary in their charges.
You will also want to check your insurance policy to determine how much you
may need to pay out of your own pocket.

Out-of-Hospital Birth

     Out-of-hospital birth is an option only for the healthy woman who is
experiencing a normal pregnancy and who has never experienced complications in
any previous pregnancies.  A woman who is experiencing a complicated pregnancy
or who may require a cesarean section will need to labor and deliver in a
hospital that is equipped to handle these situations.  If you are considering
an out-of-hospital birth, it is extremely important to keep in mind that
emergencies can develop rapidly and often without warning during labor and
delivery.  Most out-of-hospital settings will not have the medications and
equipment that may be necessary in an emergency.
     If out-of-hospital birth is an option for you, you will need to find out
what services are available in your community.  Many cities now have birthing
centers.  These are freestanding facilities that are staffed by medical
professionals.  Birthing centers offer an alternative to hospital birth for
the healthy pregnant woman who is not at increased risk of experiencing a
complicated birth (many of these centers will not accept women who have a
greater likelihood of needing a cesarean section or other type of
sophisticated medical intervention).
     These centers attempt to offer "the best of both worlds" by providing
family-centered care in a homelike setting but with the security and safety
provided by a professional staff, up-to-date monitoring equipment, and
prearranged emergency backup.  These centers can deal with normal pregnancies,
and they may have the equipment necessary to detect complications that may
develop.  They may not, however, have the equipment or staff necessary to deal
with such complications.  A pregnant woman who experiences an unexpected
complication will be transferred immediately to a hospital that is equipped to
handle the problem.
     Before you consider using a birthing center, make certain that it is
licensed by the state.  You should also check with your insurance company to
be sure that your policy covers childbirth in a freestanding birthing center.
     Another alternative to traditional hospitals is home birth.  During the
last two decades, the number of home births in the United States has greatly
increased, as parents have attempted to make childbirth a more personal and
family-oriented experience.  The delivery is performed by either a doctor or a
midwife and generally takes place in the family's bedroom.
     Medical intervention is often not necessary for a healthy woman who is
experiencing a normal labor.  During a home birth, a woman who does develop
an unexpected complication must be transferred to a hospital immediately.
This disadvantage of out-of-hospital birth should be carefully considered by
all women planning birth outside the hospital.
     When inquiring about out-of-hospital birth services, find out what
drugs and equipment are generally used.  Are intravenous fluids, pain
medications, or fetal monitors used?  What emergency equipment is on hand for
every birth?
     You will also need to know what hospital is used in case a transfer
becomes necessary.  Who makes the transfer arrangements?  Is an ambulance
readily available?  How far away is the backup hospital?
     Out-of-hospital birth offers parents certain advantages and experiences
that they may not have with a traditional hospital birth.  They have more
control over birth procedures and there are few routines that need to be
followed.  Contact with the baby after birth is limited only by the
parents' wishes.  When considering these advantages, however, you must weigh
them carefully against the risks to both mother and baby if an emergency
should occur.


Packing Your Suitcase

     The following are some items that you may want to take with you to the
hospital when you go into labor.  Pack your bags at least two weeks before
your due date so that you do not have to rush around at the last minute.

For the mother during labor:
  -  Massage oil (not lotion) or powder (cornstarch is best)
  -  Toothbrush and toothpaste
  -  Lip balm
  -  Rolling pin, tennis balls, or other massage aids
  -  Hot-water bottle or plastic ice pack for comfort
  -  Juice, ice pops, or sour-candy suckers
  -  Music tapes and a battery-operated tape machine
  -  Cotton socks
  -  Hair clips or rubber bands
  -  Breath spray

For the father:
  -  Food/snacks
  -  Breath mints or toothbrush
  -  Camera and film
  -  Watch with a second hand for timing contractions
  -  Pencil and paper

For the baby:
  -  Warm hat (maybe provided by the hospital)
  -  Stretch suit or T-shirt, receiving blanket, warm blanket and booties
     (depending on weather), and four or five diapers for taking baby home
  -  Car seat

For the mother after birth:
  -  Nursing bras (two or three)
  -  Nursing pads
  -  Breast cream or lotion
  -  Personal hygiene items, cosmetics, and a shower cap
  -  Phone numbers of people to call with the good news
  -  Reading and writing materials, birth announcements, stamps, address book
  -  Comfortable clothes to wear home (stick with adjustable or loose-fitting
     clothing so that it's sure to fit)