Discussion points

It is wise to discuss a number of issues well in advance: 

Who is going to support you during labor? Your midwife? The nurse?

 How often does she listen to the fetal heartbeat during labor? Are they making a CTG as a routine when you come in? (this means that you have to lie down on a bed for at least 20 min)  Does your midwife/ob use a partogram

How will labor be diagnosed? Do they believe in latent phase? Are all the midwives and ob’s on the same page about this or are you left to the personal convictions of the person on call? Do they perform an amniotomy as a routine with the first vaginal exam? Or only when failure to progress is diagnosed? Does the hospital offer augmentation during the night if needed? What are the options for pain relief? 

How often does your midwife or ob cut an epis and for what reason? Do they have  experience with the birth stool, birthing on hands and knees or in the bath? 

There are lots of evidence that delayed cordclamping is good for the baby, but still this is not done everywhere as a routine.  If the cord is not clamped until pulsations have ceased, the baby gets warm blood full of oxygen pumped into him. He needs this till his own lungs are working properly. This often doesn’t take more than a few minutes but some baby’s need a bit more time. What is the routine in their practice and in the hospital? 

Do they actively manage the birth of the placenta or will they just wait. Are you offered  choice in this?

Arom, cordclamping, active management of the placenta are interventions in your body or the babys’.  Permission should be requested  and should be given. But in practice, on a daily basis women have their membranes ruptured, or are given shots of pitocin without any explanation, without so much as “by your leave”, just an announcement.

Maybe you think it’s fine, the midwife and obstetrician  are highly trained professionals. But maybe you want to have the final word about what is done to your body, your baby. When you are in labor you will not be up for discussions.                                                              So discuss things in advance!