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Important Things to Decide Before the Baby Is Born

Physical Limitations
Make some advance preparations for the fact that you are going to have some physical limitations before and after the birth of your new baby.

Before the baby's birth, you will be extremely fatigued, due to hormonal changes and breaks in your sleep pattern, not to mention the fact that the size of your belly gets in the way of sleeping in a comfortable position. This would be a good time to get some extra help from family and friends if you want to clean the house or complete any projects.

Avoid any activities that could jeopardize your health or the health of your baby, meaning that you don't want to fall, be injured, or traumatize your body in any fashion. Use common sense in your activities because you will be less able to get around. Let family members know that they may have to pick up some of the slack here, say helping with the gardening, housework, shopping, or other chores.

Be sure to line up help for yourself after the baby is born; for example, it's a great time for grandparents to be useful and welcome. Work out a schedule so that you're covered for at least the first few weeks after delivery – the longer, the better. Believe me, you won't want to tackle those weeks alone.

Here are some areas of your life that will change after the baby is born:

Who's In, Who's Out
Here is the most important question, and also the most avoided question of any pregnancy: Who will accompany you into the labor and delivery room?

OK, there are really two questions here: Who do you want to be there during labor and who do you want to be there during the delivery? The labor and delivery rooms are often two separate places, although in many hospitals, the labor and delivery rooms are one and the same spot now.

Determine in advance which people are invited to experience which areas. For example, you might have frequent visitors coming and going during your labor, but you don't want them around during the delivery. Having people around to watch the labor is one thing; having them there to experience the birth might be too personal for you. Or you might not want anyone to see you in the throes of labor and delivery. That's alright, too.

If you want to confine your birth experience to you and your spouse (plus a few doctors and nurses), that's perfectly normal. As you near the actual delivery time, you just need to send all unnecessary people into the waiting room, so that you can experience the birth alone. Just let your nurse know your plans in advance, and she'll be the bad guy for you.

In general, you will have to follow the guidelines of the labor and delivery department of the hospital that you choose, so the number of people in attendance is really up to them (and their policies). Because of this, it's wise to visit the hospital early, look around, and check out how everything functions, so you don't have any surprises when you arrive. If you have questions, ask them in advance. Usually, labor and delivery rooms are among the friendliest places in the hospital.

In this hierarchy, the nurses manage everything in terms of your care (not the doctors). You will end up loving these nurses (male or female) who track their patients' needs at all times and establish who belongs in the L&D room and who doesn't. If you tell a nurse that you don't want an estranged boyfriend or ex-husband to be present, the nurse will keep them out.

Generally, when it comes time for delivery, the optimum number of extra people in the room is about two, in addition to the patient. The reason being that the space is small, and there has to be enough room for the doctors and nurses to perform their functions. Although medical personnel are sensitive to the patient's need for a support person, keep in mind that their first priority is to their two patients – mother and child. Everyone else is incidental.

From the Doctor's Perspective...
In most births (vaginal deliveries), the extra person is the patient's significant other and maybe one other person, say a mother, sister, or close friend. However, I've been in deliveries where there were five extra people. I've also been in deliveries where there was just the patient. The important thing is to figure this out in advance, so there are no surprises or arguments at a time that should be happy. Then let the nurse know, and she'll handle the rest.

Choosing Your Support Person
If you are married, chances are your support person will be your husband. If you're not married, you might have other options. Pick your support person carefully. It should be someone who is calm because that person will have to keep you calm and peaceful when you're at your most agitated state. Your support person should also know you well and be the encouraging type, so that he or she can help you through potentially long hours of labor and delivery. Doctors and nurses rely on the support person to "translate" directions to the patient, who might not be at her best in terms of listening. Also, if the patient has any questions, often the support person will query the doctor or nurse for the patient, who, obviously, has more important things on her mind.

Don't be disappointed if your support person flakes out and doesn't really come through in the way you expected. This is probably a new experience for him or her as well. Even if your support person is just in the room to give you moral support, share the joy, or feed you ice chips – let's face it, passive support is better than nothing.

One Person's Support is Another Person's Annoyance
Your support person may be your best friend (or spouse) and the most wonderful person in the world, but during labor, he or she may bug you to death (for absolutely no reason). Keep in mind that you're not at your most charming when you're in labor. Little things can bug you a lot.

For example, Dr. John recalls when he was a resident hearing a woman in labor moaning, the nurse counting to 10, and then a slapping sound. Finally, he could stand the suspense no longer, so he went into the room and witnessed the woman in labor slapping her husband. That's right – slapping! The husband was looking like a nice, supportive husband who held his wife's head every time she had a contraction, but after she finished, she turned her head and slapped him across the face. Dr. John left the room and ran into the patient's mother-in-law. "I'm worried," she said. "Nothing to be worried about," said Dr. John. "The patient is doing fine." "I'm not worried about the patient," she said. "That's my son in there."

Meanwhile, the nurse called Dr. John back and asked when they were going to do a c-section. Dr. John was bemused and said, "What are you talking about, nurse? What would warrant a c-section?" "How about spousal abuse?" she replied with a smile.

If You Have a C-Section
If you have a cesarean section, then everything changes as far as who can watch the birth. Typically, only one additional person is allowed in the room for a c-section because you will be going into an operating room and a sterile environment. Additional hospital personnel will be necessary to take care of the mother and the baby because the risk is elevated. Also, more attention needs to be paid to the mother, and extra people would just get in the way.

In the case of a c-section, one extra person will be allowed into the room, but only in a mask, cap, and gown (sterile applies to everyone). He (or she) will be placed at your head, and there will be a curtain between your stomach area where the doctors are working and your line of sight. The extra person can look over the curtain and tell you what is going on, but you won't be able to see anything. Sometimes, the doctors are good about relaying information, but often they are busy handling the operation. The anesthesiologist will also be at your head during surgery, watching your vital signs.

Videotaping Your Future Star
Everyone has a different opinion about videotaping and photographing the birth, and hospitals have different policies, so it's wise to check out the policies first. Although you might think that you can get everything on camera, actually, that might not be the case. Hospitals will generally let you film before and after the delivery, but not necessarily during it. Blame the insurance companies and lawyers for this new rule, which is based on legal issues.

If you have a boy baby, the doctors will ask you if you want to have him circumcised, which involves the removal of the foreskin on the boy's penis. This practice is fairly common in the U.S., but not as common in other countries. Sometimes, it is determined by your culture or heritage, although often the father seems to be the one to decide whether or not the baby will be circumcised.

There is a wealth of opinions, both pro and con about circumcision, and you would be wise to research the subject before proceeding. In the past, the procedure was performed to stave off infections, but many people feel that with today's health standards, it is no longer necessary. Most pediatricians will agree with whatever the parents want to do. If you want it done (or not), you should notify your family pediatrician, who will stop by the hospital to check the baby anyway. At this time, the procedure can be performed.

Parents will be counseled extensively about the risks of the procedure and must sign a consent form in order for the doctor to perform the procedure, which will take place in the nursery. Most of the time, the baby's foreskin will be anesthetized, so the baby doesn't feel any pain. The baby will be uncomfortable for a few moments when the anesthetic is given. Sometimes, the foreskin will come off immediately, but it may take a couple of days or a week or so to fall off.

It's Your Decision
As a mother of three boys, I decided against circumcision, figuring that the boys weren't born that way and natural must be better. This was strictly my opinion and my husband's, but we did discuss it first with our pediatrician. Our doctor said that in today's society where hygiene is not an issue, circumcision is no longer necessary. Other pediatricians might feel differently. They might cite the fact that the boys will "look" different or might need to have the procedure done later in life when it would be more painful. My boys have never had any problems, and they are now grown. Moral of the story: Do your own research and make your own decision.

Breast Feeding
By now, you should have an inkling of whether you will breast-feed or bottle-feed your baby. As soon as the baby is born, you will have an opportunity to feed the baby fairly soon. Doctors do stress that there is a wealth of information showing that breast-feeding has significant advantages for the baby over formula-feeding. Breast-fed babies have fewer problems with infections, bond better to the mother, and receive better nutrition, according to the research. Simply put, babies who breast-feed are healthier than babies who don't, which is why women are strongly encouraged to follow this practice. If for some reason you can't or don't want to breast-feed, let the nursing staff know so that they have a plan in place for bottle-feeding the baby.

If you're thinking about nursing your baby, most hospitals have lactation consultants who will help you get started and give you encouragement. Nursing a baby is not as instinctual as you might imagine, but both mother and baby can be taught. It can be painful in the beginning as you're getting started and used to it, but well worth it to persevere.

Reproduced from Absolute Beginner's Guide to Pregnancy, by John Adams and Marta Justak, by permission of Pearson Education. Copyright © 2005 by Que Publishing. Please visit Amazon to order your own copy.

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