NYP Brooklyn Methodist

Winter 2018

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As Rachel thought about creating her birth plan, she knew she needed to answer several questions about her goals, including: How does she want to manage pain? During labor, women can opt for intravenous (IV) pain medication or an epidural—a type of regional anesthesia that helps numb the lower half of the body—or they can explore drug-free alternatives. "On their birth plan, women should list pain control options like an epidural, breathing and movement, using a birthing ball, or going into and out of the shower every hour or so for comfort," says Kayann Stephens, R.N., nurse manager of labor and delivery at NYP Brooklyn Methodist. "Women who have hired a doula—a support person who has extra training in caring for laboring women—should also note that on the birth plan." Who does she want in the delivery room with her, and what type of "tone" does she want to set for the birth? NYP Brooklyn Methodist allows moms to have two people—often their partner and an additional support person—in the room with them during delivery. As long as things are progressing smoothly, women may also choose to display photographs they bring from home, play soft music and dim the lights to create a more soothing environment. RECOMMENDED ADDITIONS Some practices are so well-validated that doctors and midwives advise all women who have had complication-free vaginal deliveries or C-sections to add them to their birth plans. These include: Skin-to-skin contact—Uninterrupted skin-to-skin contact helps moms bond with their babies, facilitates breastfeeding, and eases the transition to life after birth for babies. "Skin-to-skin contact is one of the best things for baby, even if moms don't plan to breastfeed," says Patricia Pierre, R.N.C.-O.B., nurse manager of the mother/baby unit at NYP Brooklyn Methodist. "Once babies are placed on their mom's chest, their temperature, blood glucose and respiration rate start to stabilize." Rooming-in with baby—"Studies show that moms and babies who aren't interrupted in their care recover much better," Ms. Pierre says. "Moms learn how to pick up on their baby's hunger cues, and their internal clocks start to remind them to breastfeed every two hours or formula-feed every three hours. This helps moms become comfortable with the routine and caring for their babies before families are discharged home." Breastfeeding—Doctors, midwives and nurses encourage women to breastfeed, when possible, but they will support the mother's preference. WHEN PLANS CHANGE If pregnancies extend past the due date or women develop complications, like gestational diabetes or high blood pressure, doctors or midwives may recommend inducing labor. Similarly, if the baby experiences distress during labor or labor fails to progress, doctors may recommend performing a C-section. In these cases, care may deviate from what women express in their birth plans, but these changes are necessary for the safety of moms and babies. K E E P I N G M O M S I N T H E K N O W NYP Brooklyn Methodist's Life Begins program offers the following educational and supportive resources for expecting and new moms. • Group labor and delivery tours are available by appointment on Tuesdays and Thursdays at 5 p.m. and on Wednesdays at 9 a.m. • A prepared childbirth course can help provide information needed to make a birth plan. The course educates couples about the three stages of labor and how to cope with and manage pain throughout each stage. It also covers circumstances under which a C-section may be necessary and details about the C-section process. The $175 fee includes enrollment in a breastfeeding course. • A breastfeeding support group for moms with babies under the age of three months meets on Tuesdays from 2:30 to 3:30 p.m. in room 3K-C of Wesley House, which is located at 501 Sixth Street, across the street from the Hospital. Mothers do not need to have delivered at NYP Brooklyn Methodist to join the group. Visit www.classes.nym.org to register for a labor and delivery tour or the prepared childbirth and breastfeeding courses. For more information about the breastfeeding support group, call 718.780.5078. "Ultimately, women need to have confidence in the person providing their health care," Dr. Lederman says. "They need to know that their doctor or midwife will do whatever is best for them and their babies." F IN D A D O C T O R 718 . 49 9.C A R E ( 2 27 3 ) 11

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