Birth Plan Guidelines: Second Stage of Labour

Now that you have completed your plan for the first Stage of Labour, you will want to consider some of the planning for the second stage of labour.

What position do you want to be in to push? Under what conditions will your doctor use forceps or a vacuum extractor? If you end up having a Caesarean, do you want to be awake during the procedure? There are many important things to think about.

Pushing

You have many choices for how you want to push your baby out. It's better to decide what you will do now, instead of waiting until it's time to push. Here are some of your options:

• Choice of position: You can use different positions to aid her pushing efforts, such as squatting, lounge position, on hands and knees, etc. Your labour and delivery nurse may suggest other positions that can also be used for pushing.
• Squatting: You can use a birth or squat bar to help push your baby out.
• Leg Support: Your support people or the nurse support your legs.
• Foot support: You can put your feet in foot pedals or stirrups.
• Spontaneous bearing down: Once the healthcare providers have said that the cervix has opened fully; you listen to your body and pushes only when you have the urge to push. 
• Directed pushing: Sometimes your only option for pushing is to do it only when directed to push by one the healthcare providers.
• Mirror: The staff can position a mirror so your can see your baby's head emerge.

Episiotomy

You should both talk with your doctor or midwife in advance about when an episiotomy might be needed. Maybe you would prefer a small tear which may also be stitched after the birth. Also, decide if you want local anaesthesia for the episiotomy and its repair. This is usually given by a local injection in the area to be repaired.

Assisted birth

Some babies need a help to be born because of a medical concern that has developed with either you or your baby. In such situations, the doctor may assist in the actual delivery with one of the following devices.

• Forceps
• Vacuum extractor

Vaginal Delivery

If you have a vaginal delivery, consider the following options that may be available to you.

• Choose a position in which to deliver your baby
• Touch your baby's head when it crowns
• Have your baby placed on your abdomen or chest right after birth
• Have either your or your partner cut the umbilical cord 
• Collect the cord blood (If parents have registered for a cord blood program, they need to bring the collection materials with them.)
• Have you hold your baby during the delivery of the placenta
• Breastfeed after the delivery
• Take the placenta home (Some cities or towns may require you to obtain a special hazardous waste container.)

Caesarean section

If an emergency occurs, a Caesarean birth might be necessary. If this happens to you, what will you do?

• Get a second opinion if time allows.
• Have your designated support person with you during the Caesarean.
• Ask if it is possible for to have an epidural so you can be awake for the birth.
• Have your designated support person hold the baby after the delivery.
• Breastfeed in recovery.

Continue reading Birth Plan Guidelines: Post Birth